0001193125-26-079454 | 10-K | XBRL Viewer | Brightspring Health Services INC

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Debt and Derivatives - Schedule of Interest Rate Swap with Notional Value (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Matured contracts
Derivative [Line Items]
Derivative, Notional Amount		$ 2,000
Matured contracts \| Credit Suisse
Derivative [Line Items]
Derivative, Notional Amount		500
Derivative, description of terms	3-year period ending September 30, 2025
Fixed rate	3.4165%
Matured contracts \| Morgan Stanley
Derivative [Line Items]
Derivative, Notional Amount		1,050
Derivative, description of terms	3-year period ending September 30, 2025
Fixed rate	3.42%
Matured contracts \| Credit Agricole Corporate and Investment Bank
Derivative [Line Items]
Derivative, Notional Amount		$ 450
Derivative, description of terms	3-year period ending September 30, 2025
Fixed rate	3.5241%
Existing contracts
Derivative [Line Items]
Derivative, Notional Amount	$ 1,500
Existing contracts \| Morgan Stanley
Derivative [Line Items]
Derivative, Notional Amount	$ 250
Derivative, description of terms	3-year period ending September 30, 2028
Fixed rate	3.177%
Existing contracts \| Credit Agricole Corporate and Investment Bank
Derivative [Line Items]
Derivative, Notional Amount	$ 500
Derivative, description of terms	1-year period ending September 30, 2026
Fixed rate	3.725%
Existing contracts \| Mizuho Capital Markets
Derivative [Line Items]
Derivative, Notional Amount	$ 500
Derivative, description of terms	1-year period ending September 30, 2026
Fixed rate	3.61121%
Existing contracts \| Credit Agricole Corporate and Investment Bank
Derivative [Line Items]
Derivative, Notional Amount	$ 250
Derivative, description of terms	3-year period ending September 30, 2028
Fixed rate	3.3315%
Forward starting contracts
Derivative [Line Items]
Derivative, Notional Amount	$ 500
Forward starting contracts \| Mizuho Capital Markets
Derivative [Line Items]
Derivative, Notional Amount	$ 500
Derivative, description of terms	2-year period ending September 30, 2028
Fixed rate	3.2022%

Related Party Transactions	12 Months Ended
Dec. 31, 2025
Related Party Transactions [Abstract]
Related Party Transactions	16. Related Party Transactions The Company was party to a Monitoring Agreement with KKR and WBA, which required payment of an aggregate advisory fee equivalent to 1% of consolidated EBITDA, payable in quarterly installments in arrears at the end of each quarter. The Monitoring Agreement terminated upon the completion of the IPO Offerings in January 2024. Prior to the termination of the Monitoring Agreement, the Company recognized $0.7 million in monitoring and advisory fees during the first fiscal quarter of 2024 as a component of selling, general, and administrative expenses in our accompanying consolidated statements of operations compared to $5.6 million for the year ended December 31, 2023. As a result of the termination of the Monitoring Agreement and in accordance with the agreement, the Company paid $22.7 million in termination fees to KKR and WBA. The termination fees were recognized in the first fiscal quarter of 2024 as selling, general, and administrative expense in our consolidated statement of operations. KKR Capital Markets LLC (“KCM”), a wholly owned subsidiary of KKR, acted as an underwriter in the IPO Offerings during the first fiscal quarter of 2024 and received $7.4 million in underwriting discounts and commission. In connection with debt refinancing in 2024 and the Revolver upsize in 2023, the Company paid underwriter, arranger, and transaction fees to KCM of $3.7 million and $2.4 million, respectively. These fees are included within selling, general, and administrative expenses in our consolidated statement of operations for the years ended December 31, 2024 and 2023. There were no similar fees paid to KCM in 2025. KKR has ownership interests in a broad range of portfolio companies, and we may enter into commercial transactions for goods or services in the ordinary course of business with these companies. We do not believe such transactions are material to our business. The Company had agreements with WBA and/or certain of its affiliates under which the Company purchases significant volume of inventory, including a Joinder Agreement to the Pharmaceutical Purchase and Distribution Agreement (the “WBAD Membership Agreement”) between WBA and AmeriSourceBergen Drug Corporation (“ABDC”). The WBAD Membership Agreement was terminated in the first fiscal quarter of 2025, and we entered into a separate agreement with ABDC on February 1, 2025.

Related Party Transactions

12 Months Ended

Dec. 31, 2025

Related Party Transactions

16. Related Party Transactions

The Company was party to a Monitoring Agreement with KKR and WBA, which required payment of an aggregate advisory fee equivalent to 1% of consolidated EBITDA, payable in quarterly installments in arrears at the end of each quarter. The Monitoring Agreement terminated upon the completion of the IPO Offerings in January 2024.

Prior to the termination of the Monitoring Agreement, the Company recognized $0.7 million in monitoring and advisory fees during the first fiscal quarter of 2024 as a component of selling, general, and administrative expenses in our accompanying consolidated statements of operations compared to $5.6 million for the year ended December 31, 2023.

As a result of the termination of the Monitoring Agreement and in accordance with the agreement, the Company paid $22.7 million in termination fees to KKR and WBA. The termination fees were recognized in the first fiscal quarter of 2024 as selling, general, and administrative expense in our consolidated statement of operations.

KKR Capital Markets LLC (“KCM”), a wholly owned subsidiary of KKR, acted as an underwriter in the IPO Offerings during the first fiscal quarter of 2024 and received $7.4 million in underwriting discounts and commission. In connection with debt refinancing in 2024 and the Revolver upsize in 2023, the Company paid underwriter, arranger, and transaction fees to KCM of $3.7

million and $2.4 million, respectively. These fees are included within selling, general, and administrative expenses in our consolidated statement of operations for the years ended December 31, 2024 and 2023. There were no similar fees paid to KCM in 2025.

KKR has ownership interests in a broad range of portfolio companies, and we may enter into commercial transactions for goods or services in the ordinary course of business with these companies. We do not believe such transactions are material to our business.

The Company had agreements with WBA and/or certain of its affiliates under which the Company purchases significant volume of inventory, including a Joinder Agreement to the Pharmaceutical Purchase and Distribution Agreement (the “WBAD Membership Agreement”) between WBA and AmeriSourceBergen Drug Corporation (“ABDC”). The WBAD Membership Agreement was terminated in the first fiscal quarter of 2025, and we entered into a separate agreement with ABDC on February 1, 2025.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

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+ Details

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 190,666	$ (18,062)	$ (154,603)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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+ Details

Goodwill and Intangible Assets - Schedule of Definite-Lived Intangible Assets, Amortization Expense (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Finite-Lived Intangible Assets, Amortization Expense, Maturity Schedule [Abstract]
2026	$ 79,888
2027	46,935
2028	39,876
2029	34,000
2030	33,108
Thereafter	130,498
Total intangible assets, Net Carrying Value	$ 364,305	$ 459,591

Document and Entity Information - USD ($) $ in Millions	12 Months Ended
Document and Entity Information - USD ($) $ in Millions	Dec. 31, 2025	Feb. 24, 2026	Jun. 30, 2025
Document Information [Line Items]
Document Type	10-K
Document Annual Report	true
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Entity Central Index Key	0001865782
Document Fiscal Period Focus	FY
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Document Period End Date	Dec. 31, 2025
Document Fiscal Year Focus	2025
Document Transition Report	false
Document Financial Statement Error Correction [Flag]	false
Entity File Number	001-41938
ICFR Auditor Attestation Flag	true
Entity Registrant Name	BrightSpring Health Services, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	82-2956404
Entity Address, Address Line One	805 N. Whittington Parkway
Entity Address, City or Town	Louisville
Entity Address, State or Province	KY
Entity Address, Postal Zip Code	40222
City Area Code	502
Local Phone Number	394-2100
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Public Float			$ 2,349
Entity Common Stock, Shares Outstanding (in shares)		193,536,850
Documents Incorporated by Reference	Portions of the Registrant’s Definitive Proxy Statement to be filed within 120 days of December 31, 2025 with the Securities and Exchange Commission in connection with its 2026 Annual Meeting of Stockholders are incorporated by reference into Part III of this Annual Report on Form 10-K.
Auditor Name	KPMG LLP
Auditor Location	Louisville, Kentucky
Auditor Firm ID	185
Auditor Opinion [Text Block]	Opinion on Internal Control Over Financial Reporting We have audited BrightSpring Health Services, Inc. and subsidiaries' (the Company) internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control – Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission. In our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control – Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission. We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (PCAOB), the consolidated balance sheets of the Company as of December 31, 2025 and 2024, the related consolidated statements of operations, comprehensive income (loss), shareholders’ equity, and cash flows for each of the years in the three-year period ended December 31, 2025, and the related notes (collectively, the consolidated financial statements), and our report dated February 27, 2026 expressed an unqualified opinion on those consolidated financial statements.
Common Stock
Document Information [Line Items]
Title of 12(b) Security	Common Stock, par value $0.01 per share
Trading Symbol	BTSG
Security Exchange Name	NASDAQ
6.75% Tangible Equity Unit [Member]
Document Information [Line Items]
Title of 12(b) Security	6.75% Tangible Equity Units
Trading Symbol	BTSGU
Security Exchange Name	NASDAQ

Property and Equipment, Net - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Depreciation expenses	$ 71.8	$ 66.8	$ 57.3

Lease Arrangements (Tables)

12 Months Ended

Dec. 31, 2025

Leases [Abstract]

Summary of Lease Expense

Lease expense is summarized as follows (in thousands):


	For the Years Ended December 31,
	2025		2024		2023
Finance leases:
Amortization of right-of-use assets	$	3,906	$	4,293	$	3,356
Interest on lease liabilities		893		2,443		2,254
Operating leases:
Operating lease cost		56,687		55,110		52,226
Short-term lease cost		6,001		4,952		5,069
Variable lease cost		8,270		8,344		8,179
Total lease costs	$	75,757	$	75,142	$	71,084

Schedule of Future Minimum Lease Payments of Leases

Future minimum lease payments of our leases as of December 31, 2025 are as follows (in thousands):


Fiscal Year	Finance Lease Costs		Operating Lease Costs
2026	$	7,833	$	53,793
2027		6,788		49,308
2028		5,193		38,989
2029		2,825		26,438
2030		461		18,491
Thereafter		50		22,491
Total future minimum lease payments	$	23,150	$	209,510
Less: imputed interest		1,812		31,154
Total present value of lease liabilities	$	21,338	$	178,356

Supplemental Cash Flow & Other Information

Summary of Supplemental Cash Flow Information Related to Leases

Supplemental cash flow information related to leases are summarized as follows (dollars in thousands):


	For the Years Ended December 31,
	2025			2024			2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from finance leases	$	(893	)	$	(2,443	)	$	(2,254	)
Financing cash flows from finance leases		(4,624	)		(4,220	)		(4,082	)
Operating cash flows from operating leases		(58,206	)		(55,269	)		(51,621	)
Right-of-use assets obtained in exchange for new finance lease liabilities		16,977			3,171			3,726
Right-of-use assets obtained in exchange for new operating lease liabilities		57,097			38,718			35,555
Weighted-average remaining lease term (in years):
Finance leases		3.3			3.1			3.1
Operating leases		4.5			4.9			5.5
Weighted-average discount rate:
Finance leases		6.7	%		6.7	%		7.2	%
Operating leases		6.7	%		6.8	%		7.1	%

Goodwill and Intangible Assets - Schedule of Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	$ 911,567	$ 975,999
Definite-lived assets, Accumulated Amortization	547,262	516,408
Total intangible assets, Net Carrying Value	364,305	459,591
Total intangible assets, Gross	1,104,817	1,111,632
Total intangible assets, Net Carrying Value	$ 557,555	595,224
Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	2 years
Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	20 years
Licenses
Schedule Of Intangible Assets [Line Items]
Indefinite-lived assets	$ 193,250	135,633
Customer Relationships
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	502,160	542,137
Definite-lived assets, Accumulated Amortization	356,146	335,647
Total intangible assets, Net Carrying Value	$ 146,014	206,490
Customer Relationships \| Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	5 years
Customer Relationships \| Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	20 years
Trade Names
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	$ 318,768	332,977
Definite-lived assets, Accumulated Amortization	154,601	140,020
Total intangible assets, Net Carrying Value	$ 164,167	192,957
Trade Names \| Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	2 years
Trade Names \| Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	20 years
Licenses
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	$ 67,395	68,425
Definite-lived assets, Accumulated Amortization	18,886	17,528
Total intangible assets, Net Carrying Value	$ 48,509	50,897
Licenses \| Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	10 years
Licenses \| Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	20 years
Doctor/Payor Network
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	$ 5,650	12,730
Definite-lived assets, Accumulated Amortization	4,987	10,965
Total intangible assets, Net Carrying Value	$ 663	1,765
Doctor/Payor Network \| Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	5 years
Doctor/Payor Network \| Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	8 years
Covenants Not to Complete
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	$ 6,654	8,790
Definite-lived assets, Accumulated Amortization	4,717	5,886
Total intangible assets, Net Carrying Value	$ 1,937	2,904
Covenants Not to Complete \| Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	2 years
Covenants Not to Complete \| Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	7 years
Other Intangible Assets [Member]
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	$ 10,940	10,940
Definite-lived assets, Accumulated Amortization	7,925	6,362
Total intangible assets, Net Carrying Value	$ 3,015	$ 4,578
Other Intangible Assets [Member] \| Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	5 years
Other Intangible Assets [Member] \| Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	7 years

Share-Based Compensation - Summary of Share Based Compensation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Share-based compensation expense	$ 10,900	$ 7,800
Cost of Goods
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Share-based compensation expense	2,704	2,115
Cost of Services
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Share-based compensation expense	3,884	3,296
Selling, general, and administrative expenses
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Share-based compensation expense	$ 52,577	$ 55,925	$ 3,780

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

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+ Details

Debt and Derivatives - Schedule of Interest Rate Swap with Notional Value (Parenthetical) (Details) $ in Millions	Dec. 31, 2025 USD ($)
Debt Disclosure [Abstract]
Notional amount, to hedge cash flow risk of variability	$ 500

Property and Equipment, Net (Tables)

12 Months Ended

Dec. 31, 2025

Property, Plant and Equipment [Abstract]

Summary of Property and Equipment, Net

Property and equipment, net is summarized as follows (in thousands):


	December 31, 2025		December 31, 2024
Land and land improvements	$	2,120	$	2,106
Furniture and equipment		244,505		201,364
Software		234,445		213,358
Buildings		9,495		8,806
Leasehold improvements		76,683		65,432
Property and equipment under finance lease (Note 13)		39,640		28,357
Construction in progress		2,679		1,039
Property and equipment		609,567		520,462
Less: accumulated depreciation		404,878		339,892
Property and equipment, net	$	204,689	$	180,570

Tangible Equity Units - Schedule of Proceeds from Issuance Allocated to Equity and Debt Based on Relative Fair Value of each TEU (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Jan. 31, 2024
Class of Stock [Line Items]
Debt Component, Less: issuance costs	$ 47,045
TEUs
Class of Stock [Line Items]
Equity Component, Fair value per unit	$ 41.3382
Equity Component, Gross proceeds	$ 330,706
Equity Component, Less : issuance costs	9,095
Equity Component, Net proceeds	$ 321,611
Debt Component, Fair value per unit	$ 8.6618
Debt Component, Gross proceeds	$ 69,294
Debt Component, Less: issuance costs	1,905
Debt Component, Net proceeds	$ 67,389
Total, Fair value per unit	$ 50	$ 50
Total, Gross proceeds	$ 400,000
Total, Issuance costs	11,000
Total, Net proceeds	$ 389,000

Significant Accounting Policies

12 Months Ended

Dec. 31, 2025

Accounting Policies [Abstract]

Significant Accounting Policies

1. Significant Accounting Policies

Description of Business

BrightSpring Health Services, Inc. and its subsidiaries (“BrightSpring,” the “Company,” “we,” “us,” or “our”) is a leading home and community-based healthcare services platform, focused on delivering complementary pharmacy and provider services to complex patients. Our platform delivers clinical services and pharmacy solutions across Medicare, Medicaid, and commercially-insured populations.

On December 7, 2017, affiliates of Kohlberg Kravis Roberts & Co. L.P. (“KKR”) and Walgreens Boots Alliance, Inc. (“WBA”) purchased PharMerica Corporation (“PharMerica”) and on March 5, 2019, expanded with the acquisition of BrightSpring Health Holdings Corp. (“BrightSpring Corp. Acquisition”). The surviving entity was renamed BrightSpring Health Services, Inc.

BrightSpring Health Services, Inc. completed its initial public offering (“IPO”) of 53,333,334 shares of its common stock at a price of $13.00 per share and its concurrent offering of 8,000,000 6.75% tangible equity units (“TEUs”) with a stated amount of $50.00 per unit in January 2024 (collectively, “the IPO Offerings”). The net proceeds from the IPO Offerings amounted to $656.5 million and $389.0 million for the common stock and TEUs, respectively, after deducting underwriting discounts, commissions, and offering-related expenses. The common stock and TEUs began trading on the Nasdaq Global Select Market on January 26, 2024 under the ticker symbols “BTSG” and “BTSGU,” respectively. BrightSpring Health Services, Inc. used a portion of the net proceeds received from the IPO Offerings to repay certain indebtedness (see Note 6) and pay termination fees in connection with the termination of our monitoring agreement with KKR and WBA (the “Monitoring Agreement”) (see Note 16). The remaining proceeds were retained for general corporate purposes.

On January 17, 2025, the Company entered into a purchase agreement to divest its community living services, home and community based waiver programs, and intermediate care facilities (the “Community Living business”). The transaction is subject to customary closing conditions and certain other antitrust laws, and is expected to close in the first fiscal quarter of 2026.

During the second fiscal quarter of 2025, WBA sold their remaining ownership interests in the Company through open market transactions and is no longer considered a related party of the Company. In June and October 2025, KKR Stockholder and certain management selling stockholders completed registered secondary public offerings of the Company's common stock (the “Secondary Offerings”). As of the second fiscal quarter of 2025, the Company no longer qualifies as a “controlled company” under the Nasdaq Stock Market LLC listing standards and is therefore required to comply with all applicable corporate governance requirements of Nasdaq, subject to phase-in rules.

The Company did not sell any shares of common stock that were offered in the Secondary Offerings. The Company did not receive any proceeds from the Secondary Offerings, other than proceeds received in connection with the cash exercise of stock options by the management selling stockholders in connection with the Secondary Offerings.

The Company did not purchase any shares of common stock that were offered in the June 2025 secondary public offering. In connection with the October 2025 secondary public offering, the Company concurrently purchased from the underwriter, out of the aggregate of 15,000,000 shares of common stock that were the subject of the October 2025 secondary public offering, 1,500,000 shares of common stock. The price per share paid by the Company was equal to the price at which the underwriter purchased the shares from the selling stockholders in the October 2025 secondary public offering. The par value of the shares repurchased and the amount paid to repurchase the shares in excess of the par value were recorded as common stock and accumulated deficit, respectively, in the consolidated balance sheets.

Principles of Consolidation

The accompanying consolidated financial statements include the accounts of BrightSpring Health Services, Inc. and its subsidiaries. The Company consolidates its majority-owned and controlled entities, including variable interest entities (“VIEs”) for which the Company is the primary beneficiary. All intercompany balances and transactions have been eliminated.

We record a noncontrolling interest for the allocable portion of income or loss and comprehensive income or loss to which the noncontrolling interest holders are entitled based upon their ownership share of the affiliate. The Company determined noncontrolling interests for certain of these VIEs to be redeemable noncontrolling interests, which are presented on the consolidated balance sheets as redeemable noncontrolling interests.

Basis of Presentation

The accompanying consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”).

Use of Estimates

The preparation of consolidated financial statements in conformity with U.S. GAAP requires us to make estimates and assumptions that affect the reported amounts and related disclosures. We rely on historical experience and on various other assumptions that we believe to be reasonable under the circumstances to make judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Significant estimates are involved in the valuation of accounts receivable, inventory, intangible assets, derivatives, contingent consideration, taxes, insurance reserves, share-based compensation, and goodwill. Actual amounts may differ from these estimates.

Revenue Recognition

The Company recognizes the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. For transactions involving the transfer of goods, revenues are primarily recognized when the customer obtains control of the products sold, which is generally upon shipment or delivery, depending on the delivery terms specified in the sales agreement. For transactions exclusively involving provision of services, revenues are recognized over time based on an appropriate measure of progress. Additionally, where we are required to collect sales taxes from our customers, revenue is recognized net of any taxes collected, and the sales tax amounts are recorded as a liability until remitted to the governmental taxing authorities. The Company’s revenue recognition policy by reportable segment is as follows:

Pharmacy Solutions

Pharmacy Solutions revenues are generated from the products and services provided in association with the distribution of prescription drugs to consumers primarily under contracts with Prescription Drug Plans (“PDPs”) under Medicare Part D, state Medicaid programs, long-term care institutions, third party insurance companies, and private payors. Services provided include individualized medication management and support, staff and patient support programs and solutions, regulatory support, and product delivery. When an order for a prescription is placed with the Company, it creates the performance obligation to deliver a prescription and related services. The performance obligation is satisfied at a point in time upon shipment for specialty pharmacies and upon delivery for home and community-based pharmacies and facility-based pharmacies. Revenues are recognized at a point in time when the associated performance obligations are satisfied at the contractual rate established at or before the time the performance obligation is satisfied.

Provider Services

Provider Services revenues are generated from providing care services directly to consumers under contracts with state, local and other governmental agencies, as well as commercial insurance companies, long-term care insurance policies, private pay customers, and management contracts with private operators. Generally, these contracts, which are negotiated based on current contract practices as appropriate for the payor, establish the terms of a customer relationship and set the broad range of terms for services to be performed at stated rates. The contracts do not give rise to rights and obligations until a service request is placed with the Company. Contract terms vary but generally are for one year or less with available renewal options and a thirty-to-sixty-day reimbursement period. When a service request is placed with the Company, it creates the performance obligation to provide a defined quantity of service hours per patient. Performance obligations to deliver patient care services are satisfied over time and revenue is recognized using a time-based input method to measure progress against the contract between the Company and the customer, given that consumers simultaneously receive and consume the benefits provided by the Company as the services are performed. Revenues are recognized over a period of time as the services are rendered at the contractual rate established at or before the time services are rendered; thus, there are no forms of variable consideration associated with the various revenue streams.

Contractual Allowances

Revenues and the associated receivables are based upon the actual reimbursements expected to be received and include contractual allowances based upon historical trends, contractual reimbursement terms, and other factors which may impact ultimate reimbursement. Amounts are adjusted to actual reimbursed amounts based upon cash receipts.

Cost of Goods and Cost of Services

We classify expenses directly related to providing goods and services, including associated depreciation and amortization expense, as cost of goods and cost of services, respectively. Direct costs and expenses primarily include cost of drugs, salaries and benefits for direct care and service professionals, contracted labor costs, insurance costs, transportation costs for clients requiring services, certain client expenses such as supplies and medicine, residential occupancy expenses, which primarily comprise rent and utilities, and other miscellaneous direct goods or service-related expenses.

Supplier Rebates

Pharmacy Solutions receives rebates on purchases from select vendors and suppliers for achieving purchase volumes. Rebates for brand name products are generally based on purchasing volumes or actual prescriptions dispensed. Rebates for generic products are primarily based on achieving purchasing volume requirements or other contractually based requirements. The Company considers these rebates product discounts, and as a result, the rebates are recorded as a reduction of product cost and relieved through cost of goods upon the sale of the related inventory or as a reduction of inventory for drugs which have not yet been sold. The rebate recorded is adjusted, if necessary, after the third party validates the appropriate data and notifies the Company of its agreement under the terms of the contract.

Cash and Cash Equivalents

Cash and cash equivalents consist of cash on hand and cash equivalents with original maturities of three months or less. The Company places its cash in financial institutions that are federally insured. The majority of the Company’s bank accounts are zero balance accounts where cash needs are funded as checks are presented for payment by the holder. Checks issued pending clearance that result in overdraft balances for accounting purposes are included in accrued expenses in our consolidated balance sheets, and the change in the related balances are reflected in operating activities in the Company’s consolidated statements of cash flows.

Accounts Receivable

Accounts receivable primarily consist of amounts due from PDPs under Medicare Part D, institutional healthcare providers, state Medicaid programs, other government agencies, third party insurance companies, and private payors. To provide for accounts receivable that could become uncollectible in the future, the Company establishes an allowance for credit losses to reduce the carrying value of such receivables to the extent it is probable that a portion or all of a particular account will not be collected, with the related expense recorded as a component of selling, general, and administrative expenses. The allowance for credit losses totaled $76.6 million and $45.0 million as of December 31, 2025 and 2024, respectively, and is reflected in accounts receivable, net of allowance for credit losses in our consolidated balance sheets.

We regularly monitor past due accounts and establish appropriate reserves to cover potential losses and consider historical experience, pricing discrepancies, the current economic environment, customer credit ratings and/or bankruptcies to develop our allowance for credit losses. We review these factors quarterly to determine if any adjustments are needed to the allowance and write off any amounts deemed uncollectible against the established allowance for credit losses. Activity in the allowance for credit losses for the years ended December 31, 2025 and 2024 included provisions of credit losses of $56.2 million and $34.0 million, respectively; write offs of $29.5 million and $40.7 million, respectively; and recoveries and other changes of $4.9 million and $5.8 million, respectively.

Inventories

Inventory is primarily located at the Company’s pharmacy locations. Inventory consists solely of finished products (primarily prescription drugs) and is valued at the lower of first-in, first-out cost or net realizable value. Physical inventory counts are performed, at a minimum, on a quarterly basis at all pharmacy sites. Inventory and cost of goods are adjusted based upon the results of the physical inventory counts.

Investments

We consolidate investments when the entity is a VIE and we are the primary beneficiary, or if we have controlling interests in the entity, which is generally ownership in excess of 50%. Third party equity interests in our consolidated joint ventures are reflected as noncontrolling interests or redeemable noncontrolling interests in our consolidated financial statements.

We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold 50% or less of the voting stock and the entity is not a VIE in which we are the primary beneficiary. The book value of investments that we account for under the equity method of accounting totaled $0.7 million and $0.7 million as of December 31, 2025 and 2024, respectively, and is reflected in other assets within our consolidated balance sheets.

Goodwill and Intangible Assets

The Company tests goodwill for impairment annually as of October 1, or more frequently if impairment indicators arise. The Company had six reporting units for the purpose of goodwill testing: Institutional Pharmacy, Home Infusion, Specialty Solutions, Hospice Pharmacy, Behavioral Health, and Home Health and Therapies. The Community Living business represents a portion of the Behavioral Health reporting unit. In 2025, 2024, and 2023, the Company performed a quantitative assessment of all reporting units as of October 1. Refer to Note 5 for discussion of results.

Our intangible assets consist primarily of customer relationships, trade names, and definite-lived licenses, which are amortized over two to twenty years, based on their estimated useful lives. We also have indefinite-lived intangible licenses. The Company tests all

intangible assets for impairment at least annually, and more frequently if impairment indicators arise. If the carrying amount of an intangible asset exceeds its fair value, an impairment loss is recognized. We elected to perform a qualitative assessment for all intangible assets for our annual impairment test in the fourth quarter of 2025, 2024, and 2023. As a result of our qualitative analyses, we determined that it was more-likely-than-not that the fair values of our indefinite-lived intangible assets were greater than their carrying values. We recorded impairment related to definite-lived intangible licenses of $10.8 million, $1.7 million, and $1.5 million for the years ended December 31, 2025, 2024, and 2023, respectively, included within selling, general, and administrative expenses on the consolidated statements of operations.

Debt Issuance Costs

The Company capitalizes financing fees related to acquiring or issuing new debt instruments. These expenditures include bank fees and premiums, legal costs, and filing fees. Debt issuance costs are capitalized and amortized as interest expense over the terms of the related debt using the effective interest rate method. Debt issuance costs related to term loans and specified maturity borrowings are presented as a direct reduction of the carrying value of the debt. Debt issuance costs related to revolving credit facilities and lines of credit are presented as other assets in our consolidated balance sheets.

Deferred Offering Costs

Deferred offering costs of $5.6 million, which consist of legal, accounting, filing, and other fees and costs directly attributable to the Company's IPO, were capitalized, and upon completion of the IPO in January 2024, were subsequently recorded in shareholders' equity as a reduction of proceeds during the first fiscal quarter. There were no deferred offering costs as of December 31, 2025 or 2024.

Derivative Financial Instruments

The Company has interest rate swap agreements to manage its interest rate exposure. The Company does not use financial instruments for trading or other speculative purposes.

The interest rate swap agreements are designated as qualifying cash flow hedging relationships and changes in the fair values that are included in the assessment of effectiveness are recognized in accumulated other comprehensive income (“AOCI”) until the hedged items affect earnings. The Company formally assesses, both at the inception of the hedging relationship and on an ongoing basis, whether the derivatives that are used in hedging relationships are highly effective in offsetting changes in cash flows of hedged transactions. The gain or loss on the derivative included in the assessment of effectiveness is reported as a component of other comprehensive income (“OCI”) and reclassified into earnings in the same period or periods during which the hedged transaction affects earnings.

The Company’s policy for treatment of discontinued derivative instruments states that the Company will discontinue hedge accounting prospectively when it determines that the derivative is no longer effective in offsetting cash flows attributable to the hedged risk, the derivative expires or is sold, terminated, or exercised, the cash flow hedge is de-designated because a forecasted transaction is not probable of occurring, or management determines to remove the designation of the cash flow hedge. Additionally, if it becomes probable that a forecasted transaction will not occur, the Company will recognize immediately in earnings gains and losses that were accumulated in OCI related to the hedging relationship. In all situations in which hedge accounting is discontinued and the derivative remains outstanding, the Company would continue to carry the derivative at its fair value on the consolidated balance sheets and recognize any subsequent changes in its fair value in earnings.

Income Taxes

The provision for income taxes is based upon the Company’s annual income or loss for each respective accounting period. The Company recognizes an asset or liability for the deferred tax consequences of temporary differences between the tax basis of assets and liabilities and their reported amounts in the consolidated financial statements. Deferred tax assets generally represent items that will result in a tax deduction in future years for which we have already recorded the tax benefit in the accompanying consolidated income statements. The Company also recognizes as deferred tax assets the future tax benefits from net operating and capital loss carryforwards.

We assess the likelihood that deferred tax assets will be realized from future taxable income. A valuation allowance is provided for deferred tax assets if it is more-likely-than-not that some portion or all of the net deferred tax assets will not be realized. The first step in determining the deferred tax asset valuation allowance is identifying reporting jurisdictions where we have a history of tax and operating losses or are projected to have losses in future periods as a result of changes in operational performance. We then determine if a valuation allowance should be established against the deferred tax assets for that reporting jurisdiction. The second step is to determine the amount of valuation allowance. We will generally establish a valuation allowance equal to the net deferred tax asset (deferred tax assets less deferred tax liabilities) related to the jurisdiction identified in step one of the analysis. In certain cases, we may not reduce the valuation allowance by the amount of the deferred tax liabilities depending on the nature and timing of future

taxable income attributable to deferred tax liabilities.

With respect to net deferred tax assets, the Company considers all available positive and negative evidence to determine whether a valuation allowance is needed. This includes an analysis of net operating loss carryforwards available under law, anticipated future income or loss, as well as tax planning strategies. If the cumulative weight of evidence suggests that it is more-likely-than-not that all or some portion of the net deferred tax assets will not be realized, a full or partial valuation allowance will be recognized based upon the qualitative and quantitative evidence examined.

Our policy is to recognize interest related to unrecognized tax benefits as interest expense, and penalties as selling, general, and administrative expenses in the consolidated statements of operations.

Legal Contingencies

We are a party to numerous claims and lawsuits with respect to various matters. Liabilities for loss contingencies arising from claims, assessments, litigation, fines and penalties, and other sources are recorded when it is probable that a liability has been incurred and the amount can be reasonably estimated. Legal costs incurred in connection with loss contingencies are expensed as incurred. See Note 15.

Insurance Losses

We self-insure a substantial portion of our general and professional liability, automobile liability, workers’ compensation risks, and health benefits, subject to certain stop loss coverage at a high level of losses. Provisions for losses for workers’ compensation risks and health benefits are based upon actuarially determined estimates and include an amount determined from reported claims and an amount based on past experiences for losses incurred but not reported. Estimates of workers’ compensation claims reserves have been discounted using a discount rate of 4.0% and 4.5% at December 31, 2025 and 2024, respectively. Provisions for general and professional and automobile liabilities are recorded on a claims-made basis, which includes estimates of fully developed losses for both reported and unreported claims. Accruals for general and professional and automobile liabilities are based on analyses performed internally by management. The liabilities are evaluated quarterly, and any adjustments are reflected in earnings in the period identified. These liabilities are necessarily based on estimates and, while we believe that the provision for loss is adequate, the ultimate liability may differ from the amounts recorded.

Fair Value of Financial Instruments

The Company uses valuation approaches that maximize the use of observable inputs and minimize the use of unobservable inputs to the extent possible. The Company determines fair value based on assumptions that market participants would use in pricing an asset or liability in the principal or most advantageous market. When considering market participant assumptions in fair value measurements, the following fair value hierarchy distinguishes between observable and unobservable inputs, which are categorized in one of the following levels:


(a) Level 1	Quoted prices in active markets for identical assets or liabilities.
(b) Level 2	Inputs other than quoted prices included within Level 1 that are observable for the asset or liability.
(c) Level 3	Unobservable inputs used in valuations in which there is little market activity for the asset or liability at the measurement date.

At December 31, 2025 and 2024, the fair value of cash and cash equivalents, accounts receivable, trade accounts payable, and accrued expenses approximated their carrying values because of the short-term nature of these instruments. The carrying amounts of the Company’s long-term debt can differ from its fair value as the principal amounts outstanding are partially subject to fixed interest rates. The estimates of fair value are generally based on Level 2 inputs, including quoted market prices or quoted market prices for similar issues of long-term debt with the same maturities. Our interest rate swaps are marked to market and therefore reflect their fair value. All debt classifications and interest rate swaps represent Level 2 fair value measurements (refer to Note 6). Contingent consideration, which is comprised of future earn-outs and a post-closing equity adjustment feature associated with an acquisition, represents a Level 3 fair value measurement as there is little or no market data available. Refer to Note 14.

Leases

We determine if an arrangement is, or contains, a lease at contract inception and recognize a right-of-use asset and a lease liability at the lease commencement date. Leases with an initial term of 12 months or less are not recorded on the consolidated balance sheet for select asset classes. The lease liability is measured at the present value of future lease payments as of the lease commencement date. The right-of-use asset recognized is based on the lease liability adjusted for prepaid and deferred rent and unamortized lease

incentives. Amortization of the right-of-use asset and accretion of the lease liability for an operating lease are recognized as a single lease cost, on a straight-line basis, over the lease term and included in cost of goods, cost of services, or selling, general, and administrative expenses on our consolidated statements of operations. A finance lease right-of-use asset is amortized on a straight-line basis over the lesser of the useful life of the leased asset or lease term, with interest costs reported separately. Variable common area maintenance and property tax expenses are expensed as incurred. Reductions of the right-of-use asset and the change in the lease liability are included within the changes in other assets and liabilities within operating activities on our consolidated statements of cash flows.

As our leases do not provide an implicit discount rate, we use our incremental borrowing rate as the discount rate for our leases, which is equal to the rate of interest the Company would have to pay on a collateralized basis to borrow an amount equal to the lease payments under similar terms. We determine the incremental borrowing rate applicable to each lease by reference to our outstanding secured borrowings. We then obtain a corporate yield curve with the same rating from an external source to adjust for differing tenors to reflect differing lease terms. We have elected to use the portfolio approach in determining our incremental borrowing rate. The incremental borrowing rate for all new or amended leases is based upon the lease terms. The lease terms for all the Company’s leases include the contractually obligated period of the leases, plus any additional periods covered by Company options to extend the leases that the Company is reasonably certain to exercise.

Certain leases provide that the lease payments may be increased annually based on the fixed rate terms or adjustable terms such as the Consumer Price Index. Future base rent escalations that are not contractually quantifiable as of the lease commencement date are not included in our lease liability.

We regularly review the carrying value of our right-of-use assets with respect to any events or circumstances that indicate a possible inability to recover their carrying amount. Indicators of impairment include, but are not limited to, loss of contracts, significant census declines, reductions in reimbursement levels, significant litigation, and impact of economic conditions on service demands and levels. Our evaluation is based on undiscounted cash flows, operating results, as well as significant events or changes in the reimbursement or regulatory environment. If the undiscounted cash flows suggest the recorded amounts cannot be recovered, the carrying values of such assets are reduced to fair value. We recorded a right-of-use asset impairment of $1.8 million, $2.3 million, and $1.0 million for the years ended December 31, 2025, 2024, and 2023, respectively, included within selling, general, and administrative expenses on the consolidated statements of operations.

Property and Equipment

Property and equipment are recorded at cost. Depreciation is recorded using the straight-line method over the estimated useful lives of the assets (generally, three to ten years for equipment and software and twenty years for buildings). Leasehold improvements are depreciated over the shorter of their estimated useful lives or the terms of their respective leases (generally, one to fifteen years).

We regularly review the carrying value of long-lived assets, with respect to any events or circumstances that indicate a possible inability to recover their carrying amount. Indicators of impairment include, but are not limited to, loss of contracts, significant census declines, reductions in reimbursement levels, significant litigation, and impact of economic conditions on service demands and levels. Our evaluation is based on undiscounted cash flows, operating results, as well as significant events or changes in the reimbursement or regulatory environment. If the undiscounted cash flows suggest the recorded amounts cannot be recovered, the carrying values of such assets are reduced to fair value. There was no impairment for the years ended December 31, 2025, 2024, and 2023.

Segments

Operating segments are defined as components of a company that engage in business activities from which it may earn revenues and incur expenses, and for which separate financial information is available and is regularly reviewed by the Company’s chief operating decision maker (“CODM”) to assess the performance of the individual segments and make decisions about resources to be allocated to the segments. The Company’s operating segments have been identified based upon similar economic characteristics, nature of services, types of customers, and how the CODM manages the business and allocates resources in accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) 280, Segment Reporting. The Company has identified three operating segments and has aggregated two of these operating segments into the Provider Services reportable segment. The Pharmacy Solutions operating segment is also a reportable segment.

In our Provider Services reportable segment, we provide a variety of services to help manage the whole-person health of our patients in their homes and communities through services such as home health care and hospice care and long-term specialty care.

Our Pharmacy Solutions segment operates long-term institutional pharmacies, hospice pharmacies, specialty oncology pharmacies, and home infusion centers. Our service offerings are impacted by medication availability and reliability, cost containment, staff and patient support solutions, and regulatory support. Our Pharmacy Solutions segment is designed to drive medication adherence, patient outcomes, process efficiency, and compliance in a number of areas.

Substantially all of the Company’s revenues are generated inside the United States, with the Provider Services segment generating insignificant amounts of revenue in Canada. Refer to Note 17 for additional information on the Company’s segments.

Share-Based Compensation

The Company measures and recognizes compensation expense for share-based compensation awards based on the fair value of each award at its grant date and recognizes expense over the related service period on a straight-line basis. The Company accounts for forfeitures of share-based compensation awards as they occur. Compensation expense for share-based payments is included in cost of goods, cost of services, and selling, general, and administrative expenses in our consolidated statements of operations.

Foreign Currency Translation

BrightSpring’s Canadian subsidiary designates its local currency as its functional currency. Operating results are translated into U.S. dollars using monthly average exchange rates, while balance sheet accounts are translated using period-end exchange rates. The resulting translation adjustments are included as a component of AOCI in shareholders’ equity. Operating results from foreign operations are not material to our consolidated financial statements.

Recently Adopted Accounting Standards

In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. This ASU requires the following disclosures on an annual basis:

•

A tabular rate reconciliation using both percentages and amounts, broken out into specific categories with certain reconciling items at or above 5% of the statutory tax further broken out by nature and/or jurisdiction;

•

Qualitative disclosure of the nature and effect of significant reconciling items by specific categories and individual jurisdictions; and

•

Income taxes paid (net of refunds received), broken out between federal, state/local and foreign, and amounts paid to an individual jurisdiction when 5% or more of the total income taxes paid.

The amendments in this ASU are effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company adopted this standard effective January 1, 2025, using the retrospective transition method. The adoption resulted in the restatement of comparative periods to reflect the new disclosure requirements. This ASU had no impact on the Company’s consolidated financial condition or results of operations. Refer to Note 8 for the related income tax disclosures.

In November 2023, the FASB issued Accounting Standards Update (“ASU”) 2023-07, Segment Reporting. This ASU requires the following disclosures on an annual and interim basis:

•

Significant segment expenses that are regularly provided to the CODM and included with each reported measure of segment profit/loss;

•

Other segment items by reportable segment, consisting of differences between segment revenue and segment profit/loss not already disclosed above;

•

Other information by reportable segment, including total assets, depreciation and amortization, and capital expenditures; and

•

The title of the CODM and an explanation of how the CODM uses the reported measures of segment profit/loss in assessing segment performance and deciding how to allocate resources.

The amendments in this ASU are effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted, and should be applied on a retrospective basis. The Company adopted the ASU for the year ended December 31, 2024. This ASU had no impact on the Company’s consolidated financial condition or results of operations. Refer to Note 17 for the related segment disclosures.

Recently Issued Accounting Standards

In November 2024, the FASB issued ASU 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses, which was further clarified in January 2025 through the issuance of ASU 2025-01. These ASUs require new financial statement disclosures to provide disaggregated information for certain types of expenses, including purchases of inventory, employee compensation, depreciation, and amortization in commonly presented expense captions such as cost of goods and services and selling, general, and administrative expenses. The amendments in this ASU are effective for annual periods beginning after December 15, 2026, with early adoption permitted. The adoption of this guidance will have no impact on the Company's consolidated financial condition or results of operations. The Company is currently evaluating the impact to the related disclosures.

In September 2025, the FASB issued ASU 2025-06, Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software, which modernizes the accounting for internal-use software costs

by removing all references to prescriptive and sequential software development stages. The new standard requires entities to consider whether significant development uncertainty has been resolved before starting to capitalize software costs and aligns disclosure requirements with ASC 360, Property, Plant, and Equipment. The ASU is effective for annual and interim reporting periods beginning after December 15, 2027, and can be applied prospectively, retrospectively, or using a modified transition method, with early adoption permitted. The Company is currently evaluating the impacts of this guidance on the consolidated financial statements and related disclosures.

Income Taxes - Schedule of Deferred Tax Assets and Liabilities (Details) - USD ($)	Dec. 31, 2025	Dec. 31, 2024
Deferred tax assets:
Accrued expenses	$ 53,538	$ 44,957
Allowance for credit losses and contractual allowances	36,980	22,546
Net operating losses	13,389	18,796
Share-based compensation	22,361	15,799
IRC 163(j) interest	67,438	96,961
Operating lease liability	65,906	62,587
Interest rate swaps	93	0
Other	29,870	21,325
Deferred tax assets	289,575	282,971
Valuation allowances	(7,128)	(8,968)
Deferred tax assets, net	282,447	274,003
Deferred tax liabilities:
Operating lease right-of-use asset	(74,027)	(60,587)
Property and equipment	(11,789)	(6,575)
Goodwill and other intangible assets	(198,377)	(190,272)
Insurance recovery	(4,432)	(8,677)
Interest rate swaps	0	(2,604)
Deferred tax liabilities	(288,625)	(268,715)
Deferred income taxes, net		$ 5,288
Deferred tax liabilities	$ (6,178)

Acquisitions

12 Months Ended

Dec. 31, 2025

Business Combination [Abstract]

Acquisitions

4. Acquisitions

2025 Acquisitions

During the year ended December 31, 2025, we completed three acquisitions within the Provider Services segment for aggregate consideration net of cash acquired of $247.0 million. We entered into these transactions in order to expand our services and geographic offerings. The operating results of these acquisitions are included in our consolidated financial statements from the respective dates of the acquisition.

Amedisys and LHC Branches Acquisition

The Company entered into a purchase agreement with Amedisys, Inc., UnitedHealth Group Incorporated and certain of their respective subsidiaries, to purchase certain Amedisys home health and hospice care centers and certain UnitedHealth Group care centers (the “Amedisys and LHC Branches Acquisition”), which is comprised of 110 branches, for a total purchase price of $246.4 million, net of cash acquired. On December 1, 2025 and December 31, 2025, the Company closed on 103 branches and 4 branches, respectively, as a part of the Amedisys and LHC Branches Acquisition for aggregate consideration of $238.5 million net of cash acquired. The closing of the remaining three branches is expected to occur in fiscal year 2026, subject to customary regulatory approvals and other closing conditions.

Upon closing, we entered into a one-year TSA with the sellers to support our post-closing operations of the Amedisys and LHC Branches Acquisition. The sellers will continue to provide certain transition services in exchange for fixed-price service fees. Transition services primarily include finance and accounting, human resources, IT, and legal and compliance services. The fees associated with the services rendered under the TSA are not material to our results of operations and are recorded within selling, general, and administrative expenses in our consolidated statements of operations.

The Amedisys and LHC Branches Acquisition provides home health and hospice care services through several legal entities in 18 states, of which 17 states have closed as of December 31, 2025. Its results are consolidated within the Provider Services segment. The allocation of the purchase price is provisional as of December 31, 2025. Provisional amounts primarily relate to licenses, certain lease right-of-use assets and lease liabilities, working capital accounts (accounts receivable and certain accruals), and the valuation of redeemable noncontrolling interests. The provisional status is due to pending third‑party valuations, receipt of additional information from the sellers, and completion of certain closing procedures. We expect to complete the purchase price allocation no later than December 1, 2026. During the measurement period, we will record adjustments to provisional amounts with a corresponding adjustment to goodwill, reflecting facts and circumstances that existed as of the acquisition dates. The following table summarizes the consideration paid (in thousands) for the Amedisys and LHC Branches Acquisition and the provisional fair value of the assets acquired and the liabilities assumed at the respective acquisition dates.


Accounts receivable	$	22,880
Prepaid expenses and other current assets		32
Property and equipment		5,580
Goodwill		175,042
Intangible assets		62,897
Operating lease right-of-use assets		12,604
Other assets		96
Trade accounts payable		730
Accrued expenses		10,631
Current portion of obligations under operating leases		4,177
Current portion of obligations under financing leases		1,746
Obligations under operating leases, net of current portion		8,427
Obligations under financing leases, net of current portion		3,570
Long-term liabilities		2,773
Redeemable noncontrolling interests		8,639
Noncontrolling interests		(21	)
Aggregate purchase price, net of cash acquired	$	238,459

The Company acquired eight joint ventures as a part of the transaction which are recorded as redeemable noncontrolling interests and noncontrolling interests on the consolidated balance sheet.

We have estimated the fair value of acquired licenses of $62.9 million based upon a third-party valuation. The definite-lived licenses have an estimated weighted average useful life of 10.0 years, and $56.0 million of licenses were assigned an indefinite life. We expect all of the goodwill will be deductible for tax purposes. The Company believes the resulting amount of goodwill reflects its expectation of synergistic benefits of the acquisition.

The Amedisys and LHC Branches Acquisition contributed $25.3 million in revenue and $1.2 million in operating income from the date acquired through the year ended December 31, 2025.

The following table contains the unaudited pro forma consolidated financial information for the year ended December 31, 2025, assuming that the Amedisys and LHC Branches Acquisition transaction closed on January 1, 2024 (in thousands):


	For The Years Ended
	December 31,
	2025		2024
Revenue	$	13,255,587	$	10,413,024
Operating income	$	318,968	$	135,722
Net income (loss) attributable to BrightSpring Health Services, Inc.	$	123,662	$	(46,201	)

These pro forma results include adjustments for current factors that would affect the business, including non-recurring transaction costs, depreciation, amortization of acquired intangible assets, and income taxes based on the Company's statutory tax rate. The unaudited pro forma financial information is not necessarily indicative of either future results of operations or results of operations that might have been achieved had the acquisition been consummated as of January 1, 2024 and does not reflect any operating efficiencies and cost savings that may be realized from the integration of the acquisition.

Others

Aggregate consideration for the two other acquisitions completed in 2025 was approximately $8.5 million. No cash was acquired as a part of these transactions. The operating results of the acquisitions are not material to our results of operations. Measurement period adjustments for these acquisitions recorded in the year ended December 31, 2025 were not material to the consolidated financial statements.

The Company expects to finalize the purchase price allocation for the 2025 acquisitions prior to the one-year anniversary date of each acquisition. During the year ended December 31, 2025, the Company incurred approximately $14.5 million in transaction costs related to all aforementioned acquisitions completed in 2025. These costs are included in selling, general, and administrative expenses in our consolidated statements of operations.

2024 Acquisitions

During the year ended December 31, 2024, we completed eight acquisitions within the Pharmacy Solutions and Provider Services segments. We entered these transactions in order to expand our services and geographic offerings. Aggregate consideration net of cash acquired for these acquisitions was approximately $110.6 million. The operating results of these acquisitions are included in our consolidated financial statements from the respective dates of the acquisition.

Haven Hospice

The following table summarizes the consideration paid (in thousands) for the September 1, 2024 acquisition of North Central Florida Hospice, Inc. (“Haven Hospice”) and the fair value of the assets acquired and the liabilities assumed at the acquisition date, which has been adjusted for immaterial measurement-period adjustments through September 1, 2025. Haven Hospice provides hospice and palliative care services in the state of Florida. Its results are consolidated within the Provider Services segment.


Inventories	$	45
Property and equipment		495
Goodwill		45,614
Intangible assets		19,860
Operating lease right-of-use assets		7,157
Trade accounts payable		1,264
Current portion of obligations under operating leases		2,235
Obligations under operating leases, net of current portion		4,922
Aggregate purchase price	$	64,750

Consideration for the Haven Hospice acquisition included a $15.0 million cash payment, $15.0 million seller note payable in 2028, and $30.0 million of the Company's common stock equal to 2,471,251 shares. The number of shares was calculated by dividing $30.0 million by a price per share equal to the average of the volume weighted average trading price of the Company's common stock on each of the fifteen consecutive trading days ending on and including the trading day that is three trading days prior to the closing date, as required by the asset purchase agreement. The sellers were restricted from trading during a 180-day lock-up period from closing with agreed-upon sale volume limitations for four years thereafter. The asset purchase agreement also includes a post-closing

adjustment feature to the extent any losses are incurred by the sellers in the sale of their common stock for four years following closing with a final equity adjustment feature (see Note 14).

The intangible assets consist of $14.8 million in indefinite-lived licenses and $5.1 million of trade name that have an estimated useful life of 10.0 years. The fair value of acquired licenses and trade name were based upon a third-party valuation. We expect all of the goodwill will be deductible for tax purposes. The Company believes the resulting amount of goodwill reflects its expectation of synergistic benefits of the acquisition.

Haven Hospice contributed $68.9 million and $19.8 million in revenue and $7.8 million and $1.0 million of operating income during the years ended December 31, 2025 and 2024, respectively. Pro forma financial data for the Haven Hospice acquisition has not been included as the results of the operations are not material to our consolidated financial statements.

Others

The following table summarizes the consideration paid (in thousands) for 2024 acquisitions, excluding Haven Hospice, and the estimated fair value of the assets acquired and the liabilities assumed at the acquisition dates, which were adjusted for immaterial measurement-period adjustments through December 31, 2025. Consideration for acquisitions by the Pharmacy Solutions and Provider Services segments was $27.0 million and $18.9 million, respectively.


Accounts receivable	$	3,749
Inventories		1,234
Prepaid expenses and other current assets		174
Property and equipment		398
Goodwill		17,721
Intangible assets		31,233
Operating lease right-of-use assets		364
Other assets		1,438
Trade accounts payable		650
Accrued expenses		7,657
Current portion of obligations under operating leases		56
Current portion of obligations under financing leases		53
Obligations under operating leases, net of current portion		308
Obligations under financing leases, net of current portion		8
Deferred income taxes, net		1,686
Aggregate purchase price, net of cash acquired	$	45,893

We have estimated the fair value of acquired customer relationships, licenses, trade names, and covenants not to compete based upon third-party valuations and/or the values assigned in prior acquisitions that were deemed comparable in nature. The intangible assets consist primarily of $22.3 million in customer relationships, $5.7 million in definite-lived licenses, $2.1 million in indefinite-lived licenses, $0.6 million in covenants not to compete, and $0.5 million in trade names. Definite-lived intangible assets have an estimated weighted average useful life of 14.9 years. We expect $12.0 million of the goodwill will be deductible for tax purposes. The Company believes the resulting amount of goodwill reflects its expectation of synergistic benefits of the acquisitions.

The above acquisitions contributed approximately $81.3 million and $59.9 million in revenue and $(0.4) million, which included $3.0 million of non-cash intangible impairment, and $5.0 million in operating (loss) income during the years ended December 31, 2025 and 2024, respectively. Pro forma financial data for the 2024 acquisitions has not been included as the results of the operations are not material to our consolidated financial statements.

Measurement period adjustments for all aforementioned acquisitions completed in 2024 recorded during the year ended December 31, 2025 were not material to the consolidated financial statements. The Company finalized the purchase price allocation for the 2024 acquisitions prior to the one-year anniversary date of each acquisition.

During the year ended December 31, 2024, the Company incurred approximately $3.4 million in transaction costs related to all aforementioned acquisitions completed in 2024. These costs are included in selling, general, and administrative expenses in our consolidated statements of operations.

The Company also purchased the remaining 30% noncontrolling interest in Gateway Pediatric Therapy, LLC during the first fiscal quarter of 2024 and the remaining 45% noncontrolling interest in Harvest Grove LTC, LLC during the third fiscal quarter of 2024. These transactions did not meet the definition of a business combination in accordance with ASC 805, Business Combinations.

- Definition

The entire disclosure for business combination.

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+ Details

Cybersecurity Risk Management, Strategy and Governance	12 Months Ended
Cybersecurity Risk Management, Strategy and Governance	Dec. 31, 2025
Cybersecurity Risk Management, Strategy, and Governance [Abstract]
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]	Risk Management and Strategy We recognize the importance of identifying, assessing, and managing material risks associated with cybersecurity threats, which include, among other things, operational risks, intellectual property theft, fraud, extortion, harm to employees or patients, and violation of data privacy or security laws. We incorporate cybersecurity practices into our Enterprise Risk Management (ERM) approach, which is subject to oversight by our Board of Directors. Our cybersecurity policies and practices are aligned with relevant industry standards and are designed to detect, prevent, contain, and respond to cybersecurity threats and incidents in a prompt and effective manner. Our cybersecurity risk management program is informed by prevailing security standards and is designed to provide a framework for evaluating and responding to cybersecurity risks. Key aspects of this risk management program include, but are not limited to: • Identifying the source of a cybersecurity threat; • Assessing the severity of a cybersecurity threat; • Implementing cybersecurity countermeasures and mitigation strategies; • Providing our employees with regular training on cybersecurity and the protection of our information systems; • Maintaining and testing a business continuity and disaster recovery program; • Maintaining insurance coverage intended to address cybersecurity and data breach risks; and • Informing and updating management and, as needed, the Audit Committee and our Board of Directors of cybersecurity incidents that may pose a significant risk for the business. Security events and data incidents are evaluated, ranked by severity, and prioritized for response and remediation. Incidents are evaluated to determine materiality, as well as operational and business impact, and reviewed for privacy impact. We deploy technical safeguards that are designed to protect our information systems, products, operations and sensitive information from cybersecurity threats. These include firewalls, intrusion prevention and detection systems, disaster recovery capabilities, malware and ransomware prevention, access controls, and data protection. We provide periodic training for all personnel regarding cybersecurity threats, with such training appropriate to the roles, responsibilities and access of the relevant Company personnel. Our policies require all workers to report any real or suspected cybersecurity events. Recognizing the complexity and evolving nature of cybersecurity threats, incidents and risks, we engage third-party experts, including cybersecurity consultants, to evaluate and support our risk management systems. We also rely on software support from third-party vendors to assist with evaluating, monitoring, and testing our information technology systems. These relationships enable us to leverage specialized knowledge and insights, to help ensure our cybersecurity strategies and processes remain effective. Our collaboration with these third parties includes regular audits, routine system monitoring, threat assessments, and consultation on potential security enhancements. We require third-party service providers with access to personal, confidential, or proprietary information to implement and maintain comprehensive cybersecurity practices consistent with applicable legal standards and industry best practices. As of the date of this Annual Report on Form 10-K, we are not aware of any cybersecurity incidents that have materially affected or are reasonably likely to materially affect the Company, including our business strategy, results of operations, or financial condition. For further discussion of the risks associated with cybersecurity incidents, as well as a description of an event that occurred in March 2023, see “Risk Factors—Risks Related to Our Business—Security breaches, loss of data, and other disruptions could compromise sensitive business or patient information, cause a loss of confidential patient data, employee data, personal information, or prevent access to critical information, and expose us to liability, litigation, and federal and state governmental inquiries and damage our reputation and brand.” Governance Our Board of Directors has overall oversight responsibility for our risk management, and delegates information security and related risk management oversight to the Audit Committee. The Audit Committee receives regular briefings on cybersecurity risks and risk management practices, including, for example, recent developments in the external cybersecurity threat landscape, evolving standards, vulnerability assessments, third-party and independent reviews, technological trends, as well as how management is addressing or mitigating those risks. The Audit Committee may also promptly receive information regarding any material cybersecurity incident that may occur, including any ongoing updates regarding the same. The Audit Committee periodically discusses our approach to cybersecurity risk management with our Chief Information Officer (CIO). Our CIO is a member of our executive management team who is principally responsible for overseeing our cybersecurity risk management program, in partnership with other business leaders across the Company. Our CIO has over twenty-five years of extensive experience in information technology and security, and works in coordination with other members of the management team, including, among others, the Chief Financial Officer and Chief Compliance Officer and their designees. We believe our business leaders have the appropriate expertise, background, and depth of experience to manage risks arising from cybersecurity threats. Our CIO, along with leaders from our privacy and corporate compliance functions, collaborate to implement a program designed to manage our exposure to cybersecurity risks and to promptly respond to cybersecurity incidents. Prompt response to incidents is delivered by multi-disciplinary teams in accordance with our incident response plan. Through ongoing communications with these teams during incidents, the CIO monitors the triage, mitigation and remediation of cybersecurity incidents, and reports such incidents to executive management, the Audit Committee and other colleagues in accordance with our cybersecurity policies and procedures, as is appropriate.
Cybersecurity Risk Management Processes Integrated [Flag]	true
Cybersecurity Risk Management Processes Integrated [Text Block]	We incorporate cybersecurity practices into our Enterprise Risk Management (ERM) approach, which is subject to oversight by our Board of Directors.
Cybersecurity Risk Management Third Party Engaged [Flag]	true
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag]	true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag]	false
Cybersecurity Risk Board of Directors Oversight [Text Block]	Our Board of Directors has overall oversight responsibility for our risk management, and delegates information security and related risk management oversight to the Audit Committee. The Audit Committee receives regular briefings on cybersecurity risks and risk management practices, including, for example, recent developments in the external cybersecurity threat landscape, evolving standards, vulnerability assessments, third-party and independent reviews, technological trends, as well as how management is addressing or mitigating those risks.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block]	Our Board of Directors has overall oversight responsibility for our risk management, and delegates information security and related risk management oversight to the Audit Committee.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block]	The Audit Committee may also promptly receive information regarding any material cybersecurity incident that may occur, including any ongoing updates regarding the same.
Cybersecurity Risk Role of Management [Text Block]	Our CIO is a member of our executive management team who is principally responsible for overseeing our cybersecurity risk management program, in partnership with other business leaders across the Company. Our CIO has over twenty-five years of extensive experience in information technology and security, and works in coordination with other members of the management team, including, among others, the Chief Financial Officer and Chief Compliance Officer and their designees. We believe our business leaders have the appropriate expertise, background, and depth of experience to manage risks arising from cybersecurity threats.
Cybersecurity Risk Management Positions or Committees Responsible [Flag]	true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]	Our CIO is a member of our executive management team who is principally responsible for overseeing our cybersecurity risk management program, in partnership with other business leaders across the Company. Our CIO has over twenty-five years of extensive experience in information technology and security, and works in coordination with other members of the management team, including, among others, the Chief Financial Officer and Chief Compliance Officer and their designees.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block]	We believe our business leaders have the appropriate expertise, background, and depth of experience to manage risks arising from cybersecurity threats.
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block]	the CIO monitors the triage, mitigation and remediation of cybersecurity incidents, and reports such incidents to executive management, the Audit Committee and other colleagues in accordance with our cybersecurity policies and procedures
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag]	true

Share-Based Compensation

12 Months Ended

Dec. 31, 2025

Share-Based Compensation

11. Share-Based Compensation

Share-Based Compensation Plans

On January 24, 2024, the Board of Directors adopted the 2024 Incentive Plan. Concurrent with the adoption of the 2024 Incentive Plan, the previously existing share-based compensation plan, the 2017 Stock Plan, was terminated and no further issuances are permitted under the 2017 Stock Plan; however, awards granted under the 2017 Stock Plan will continue to be governed by their existing terms.

The Company recorded share-based compensation expense on the consolidated statements of operations for the periods indicated as follows (in thousands):


	For The Years Ended December 31,
	2025		2024		2023
Cost of goods	$	2,704	$	2,115	$	—
Cost of services	$	3,884	$	3,296	$	—
Selling, general, and administrative expense	$	52,577	$	55,925	$	3,780

In addition to the amounts above, the Company recognized $10.9 million, and $7.8 million of share-based compensation expense attributable to discontinued operations for the years ended December 31, 2025 and 2024, respectively. Share-based compensation expense attributable to discontinued operations for the year ended December 31, 2023 was immaterial.

2017 Stock Plan

In January 2018, the Compensation Committee of the Company’s Board of Directors approved a grant of 4,874,558 options in the Company under a stock option plan established in 2017 to key members of the Company’s management. The options are divided into tranches: (i) 50% vest based on the passage of time over five (5) years (the “Time-Based Options”), (ii) 25% vest based on the achievement of annual adjusted EBITDA targets over five (5) years (the “Tier I Performance Options”) and (iii) 25% vest based on KKR recovering a specified return on its investment or internal rate of return (the “Tier II Performance Options”).

Following the BrightSpring Corp. Acquisition in 2019, the Compensation Committee of the Company’s Board of Directors approved the modification of the previously granted Tier I and Tier II Performance Options. Tier 1 Performance options now vest upon the attainment of Sponsor Month over Month (“MoM”) (quotient obtained by dividing sponsor cash available by sponsor cash invested) of at least 2.0 or greater and Tier II Performance Options vest upon the attainment of a Sponsor MoM of at least 2.5 or greater. The MoM levels are considered a market condition which also create an implied performance condition because the MoM levels cannot be achieved without the occurrence of a liquidity event. In January 2024, the Compensation Committee of the Company’s Board of Directors approved the vesting of Tier I performance-vesting options in connection with the IPO Offerings.

All options have a 10-year life and we record forfeitures as they occur.

Concurrent with the adoption of the 2024 Incentive Plan on January 24, 2024, no further awards are authorized to be granted under the 2017 Stock Plan.

2024 Incentive Plan

The 2024 Incentive Plan initially reserved 17,119,039 shares for issuance and provides for the granting of various forms of equity awards including non-qualified options and incentive stock options, restricted shares of our common stock, restricted stock units, other equity-based awards tied to the value of shares, and cash-based awards.

Under the 2024 Incentive Plan, the Company granted stock options, representing options to purchase shares of the Company’s common stock at a stated price, and RSUs, which represent the conditional right to receive one share of common stock, both upon satisfaction of a vesting requirement. Stock options and RSUs granted under the 2024 Incentive Plan vest upon the satisfaction of time-based requirements. We recognize expense for stock options and RSUs over the vesting term based on the grant date fair value of the award. In each case, vesting of the Company’s outstanding and unvested stock options and RSUs is contingent upon the holder’s continued service through the date of each applicable vesting event. The options all have a 10-year life and we record forfeitures as they occur.

Summary details for RSUs

The following table summarizes the RSU activity under the 2024 Incentive Plan for the period presented:


	Units			Weighted Average Grant Date Fair Value		Weighted Average Remaining Contractual Term (years)		Aggregate Intrinsic Value (in millions)
Outstanding RSUs at January 1, 2025		10,587,226		$	11.85		2.51	$	180.3
Granted		1,931,654			17.93
Forfeited		(1,364,458	)		11.64
Vested		(1,948,306	)		14.03
Outstanding RSUs at December 31, 2025		9,206,116		$	12.68		1.73	$	344.8

As of December 31, 2025, there was $53.9 million of unrecognized compensation cost that is expected to be recognized over a weighted-average period of 2.9 years related to unvested RSUs, of which, $13.3 million relates to awards associated with discontinued operations. The vesting terms of all RSUs range from 0.25 to 5 years. The total intrinsic value of RSUs vested during the years ended December 31, 2025 and 2024 was $42.0 million and $3.1 million, respectively. The excess tax benefit associated with vested RSUs for the years ended December 31, 2025 and 2024 was not material.

Summary details for Stock Options

The following table summarizes the Time-Based Options stock incentive plan activity under the 2017 Stock Plan and the 2024 Incentive Plan for the period presented:


	Number of Shares			Weighted Average Exercise Price		Weighted Average Grant Date Fair Value (in millions)			Aggregate Intrinsic Value (in millions)		Weighted Average Remaining Contractual Term (years)
Outstanding options at January 1, 2025		8,278,818		$	9.98	$	35.5		$	64.2		6.1
Granted		3,009,601			17.70		24.9
Forfeited, repurchased or expired		(406,848	)		13.94		(2.6	)
Exercised		(1,010,014	)		8.40		(3.5	)
Outstanding options at December 31, 2025		9,871,557		$	12.35	$	54.3		$	247.8		6.4

Exercisable options at December 31, 2025		6,065,430		$	9.52	$	23.70		$	168.4		4.8

The following table summarizes the Tier I and II Performance Option stock incentive plan activity under the 2017 Stock Plan for the period presented:


	Number of Shares			Weighted Average Exercise Price		Weighted Average Grant Date Fair Value (in millions)			Aggregate Intrinsic Value (in millions)		Weighted Average Remaining Contractual Term (years)
Outstanding options at January 1, 2025		6,656,999		$	7.82	$	13.8		$	63.9		5.0
Granted		—			—		—
Forfeited, repurchased or expired		(366,842	)		12.21		(1.0	)
Exercised		(2,340,254	)		7.07		(4.6	)
Outstanding options at December 31, 2025		3,949,903		$	7.86	$	8.2		$	116.9		4.0

Exercisable options at December 31, 2025		880,300		$	9.13	$	2.00		$	24.9		4.3

Cash received from stock option exercises for the years ended December 31, 2025, 2024 and 2023 was $25.3 million, $1.5 million, and $0.6 million, respectively. The excess tax benefit associated with stock options for the year ended December 31, 2025 was $13.2 million. There were no material tax benefits realized in our tax returns from tax deductions associated with share based compensation for 2024 and 2023.

As of December 31, 2025, there was $13.1 million of unrecognized compensation cost that is expected to be recognized over a weighted-average period of 2.1 years related to unvested stock options. The total intrinsic value of stock options exercised in the years ended December 31, 2025, 2024, and 2023 was $64.5 million, $1.5 million, and $1.1 million, respectively. The total fair value at grant date of awards that vested was $8.5 million, $14.6 million, and $3.6 million during the years ended December 31, 2025, 2024, and 2023, respectively.

Fair Value Assumptions

The Company estimates the fair value of options granted using the Black-Scholes-Merton model for Time-Based Options under the 2017 Stock Plan and 2024 Incentive Plan, and a Monte Carlo simulation for Performance Options granted under the 2017 Stock Plan. The assumptions used to calculate the fair value of options granted are evaluated and modified, as necessary, to reflect current market conditions and experience. The Company estimates the volatility of its common stock utilizing the historical re-levered volatility, re-levered to account for differences in leverage, of the Company and its peer-group. The peer-group utilized consisted of eight companies, in the same or similar industries as the Company. The risk-free rate is based on the U.S. Treasury yield curve in effect at the time of grant for the expected term of the option. The dividend yield was based on the expectation that no dividends will be paid. The Company has never paid cash dividends on its common stock and does not anticipate paying cash dividends in the foreseeable

future. In 2025, 2024, and 2023, the Company used a Simplified Method to estimate the expected term for the Time-Based Options, which assumes that options will be exercised early at a uniform rate over the period between vesting and the end of the contractual term, as adequate historical experience is not available to provide a reasonable estimate. For the Tier I and II Performance Options, the Company used management estimates of the performance events that trigger vesting and subsequent exercising of the options.

The following table summarizes the weighted average assumptions used to estimate the fair value of options granted during the periods presented:


	2025		2024		2023
Expected volatility (range)	40.0 - 42.0%		43.8 - 52.5%		35.0 - 50.0%
Risk free interest rate (range)	3.6 - 4.1%		3.9 - 4.1%		4.2 - 5.5%
Expected dividends		—		—		—
Average expected term (years)	6.0		6.0		0.5 - 7.5
Average fair value per share of time-based stock options based on the Black-Scholes-Merton model (dollars)	$	8.33	$	6.86	$	9.69
Average fair value per share of performance stock options based on the Monte Carlo simulation (dollars)		—		—	$	3.10
Weighted average fair value of options granted (in millions)	$	25.06	$	11.40	$	9.20

Share-Based Compensation - Summary of Stock Options (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	12 Months Ended
	Jan. 31, 2018	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Weighted Average Grant Date Fair Value (in millions)
Granted		$ 25,060	$ 11,400	$ 9,200
2017 Stock Plan
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Outstanding [Roll Forward]
Number of Shares, Granted	4,874,558
Time-Based Options \| 2017 Stock Plan and 2024 Incentive Plan
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Outstanding [Roll Forward]
Number of Shares, Outstanding options at January 1, 2025		8,278,818
Number of Shares, Granted		3,009,601
Number of Shares, Forfeited, repurchased or expired		(406,848)
Number of Shares, Exercised		(1,010,014)
Number of Shares, Outstanding options at December 31, 2025		9,871,557	8,278,818
Number of Shares, Exercisable options at December 31, 2025		6,065,430
Weighted Average Exercise Price
Outstanding options at January 1, 2025		$ 9.98
Granted		17.7
Forfeited, repurchased or expired		13.94
Exercised		8.4
Outstanding options at December 31, 2025		12.35	$ 9.98
Exercisable options at December 31, 2025		$ 9.52
Weighted Average Grant Date Fair Value (in millions)
Outstanding options at January 1, 2025		$ 35,500
Granted		24,900
Forfeited, repurchased or expired		(2,600)
Exercised		(3,500)
Outstanding options at December 31, 2025		54,300	$ 35,500
Exercisable options at December 31, 2025		23,700
Aggregate Intrinsic Value, Outstanding options		247,800	$ 64,200
Aggregate Intrinsic Value, Exercisable options at December 31, 2025		$ 168,400
Weighted Average Remaining Contractual Term, Outstanding options		6 years 4 months 24 days	6 years 1 month 6 days
Weighted Average Remaining Contractual Term, Exercisable options		4 years 9 months 18 days
Tier One and Two Performance Option [Member] \| 2017 Stock Plan
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Outstanding [Roll Forward]
Number of Shares, Outstanding options at January 1, 2025		6,656,999
Number of Shares, Forfeited, repurchased or expired		(366,842)
Number of Shares, Exercised		(2,340,254)
Number of Shares, Outstanding options at December 31, 2025		3,949,903	6,656,999
Number of Shares, Exercisable options at December 31, 2025		880,300
Weighted Average Exercise Price
Outstanding options at January 1, 2025		$ 7.82
Forfeited, repurchased or expired		12.21
Exercised		7.07
Outstanding options at December 31, 2025		7.86	$ 7.82
Exercisable options at December 31, 2025		$ 9.13
Weighted Average Grant Date Fair Value (in millions)
Outstanding options at January 1, 2025		$ 13,800
Forfeited, repurchased or expired		(1,000)
Exercised		(4,600)
Outstanding options at December 31, 2025		8,200	$ 13,800
Exercisable options at December 31, 2025		2,000
Aggregate Intrinsic Value, Outstanding options		116,900	$ 63,900
Aggregate Intrinsic Value, Exercisable options at December 31, 2025		$ 24,900
Weighted Average Remaining Contractual Term, Outstanding options		4 years	5 years
Weighted Average Remaining Contractual Term, Exercisable options		4 years 3 months 18 days

Acquisitions - Schedule of Unaudited Pro Forma Consolidated Financial Information (Details) - Amedisys and LHC Branches Acquisition - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2025	Dec. 31, 2024
Business Combination, Pro Forma Information [Line Items]
Revenue	$ 25,300	$ 13,255,587	$ 10,413,024
Operating income	$ 1,200	318,968	135,722
Net income (loss) attributable to BrightSpring Health Services, Inc.		$ 123,662	$ (46,201)

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Earnings Per Share ("EPS") (Tables)

12 Months Ended

Dec. 31, 2025

Earnings Per Share [Abstract]

Summary of Basic and Diluted Net Income (Loss) Per Share

The following table sets forth the computation of basic and diluted net income (loss) per share attributable to common shareholders (in thousands, except per share amounts):


	For The Years Ended December 31,
	2025			2024			2023
Numerator:
Net income (loss) from continuing operations	$	104,796		$	(68,931	)	$	(182,266	)
Less: Net loss attributable to noncontrolling interests		(1,553	)		(2,459	)		(2,232	)
Net income (loss) from continuing operations attributable to common shareholders		106,349			(66,472	)		(180,034	)
Net income from discontinued operations		84,317			48,410			25,431
Net income (loss) attributable to common shareholders	$	190,666		$	(18,062	)	$	(154,603	)

Denominator:
Weighted-average shares outstanding - basic		202,564			192,997			117,868

Effect of dilutive securities:
Stock options		8,865			—			—
RSUs		8,345			—			—
TEUs		—			—			—
Weighted-average shares outstanding - diluted		219,774			192,997			117,868

Basic income (loss) per share attributable to common shareholders:
Continuing operations	$	0.53		$	(0.34	)	$	(1.53	)
Discontinued operations	$	0.41		$	0.25		$	0.22
Net income (loss) per share	$	0.94		$	(0.09	)	$	(1.31	)

Diluted income (loss) per share attributable to common shareholders:
Continuing operations	$	0.48		$	(0.34	)	$	(1.53	)
Discontinued operations	$	0.39		$	0.25		$	0.22
Net income (loss) per share	$	0.87		$	(0.09	)	$	(1.31	)

Summary of Shares Excluded from Computation of Diluted Net Income (Loss) Per Share

The following potentially common share equivalents were excluded from the computation of diluted net income (loss) per share because their effect would have been anti-dilutive for the periods presented, as well as options that are contingent upon the satisfaction of certain conditions which were not satisfied by the end of the period (in thousands):


	For The Years Ended December 31,
	2025		2024 (1)		2023 (1)
Stock options		259		14,936		14,140
RSUs		—		10,587		—
TEUs		—		—		—
Total		259		25,523		14,140

(1) The dilutive effect of stock options were excluded from the computation of loss per share because the assumed proceeds from the awards' exercise were greater than the average market price of the common shares.

Debt and Derivatives - Additional Information (Details)				3 Months Ended	12 Months Ended
Debt and Derivatives - Additional Information (Details)	Dec. 11, 2024 USD ($)	Feb. 21, 2024 USD ($)	Mar. 05, 2019 USD ($)	Mar. 31, 2024 USD ($)	Dec. 31, 2025 USD ($)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Sep. 17, 2024 USD ($)	Sep. 16, 2024 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)
Debt Instrument [Line Items]
Debt to EBITDA ratio					6.9
Revolving credit facility loans					35.00%
Repayment of borrowings					$ 50,275,000	$ 3,396,334,000	$ 30,441,000
Loss on extinguishment of debt						12,726,000
Fair value of interest rate asset swaps					400,000	10,600,000
Interest received					15,200,000	35,300,000	$ 31,400,000
Pre-tax gains					(800,000)
Revolving Credit Facility
Debt Instrument [Line Items]
Line of credit facility, maturity date		Jun. 30, 2028
Debt instrument, floor rate		0.00%
Line of credit facility, maximum borrowing capacity					475,000,000
Borrowings outstanding						63,300,000
Line of credit facility, remaining borrowing capacity					475,000,000	411,700,000
Revolving Credit Facility \| SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)		3.25%
Letter of Credit
Debt Instrument [Line Items]
Borrowings outstanding					0	0
LC Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity								$ 65,000,000	$ 55,000,000
Line of credit facility, remaining borrowing capacity					2,200,000	3,200,000
Letter of credit outstanding amount					$ 62,800,000	$ 61,800,000
First Lien Credit Agreement
Debt Instrument [Line Items]
Line of credit facility, agreement date			Mar. 05, 2019
Repayment of borrowings		$ 343,300,000
Line of credit facility, maturity date		Feb. 21, 2031
Debt instrument, floor rate			0.00%
Principal at issuance (as a percent)		0.25%	0.25%
First Lien Credit Agreement \| SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)		3.25%	3.25%
First Lien Credit Agreement \| ABR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)			2.25%
First Lien Credit Agreement \| Tranche B-1 Term Loan
Debt Instrument [Line Items]
Principal amount			$ 1,650,000,000
Delayed draw			150,000,000
Line of credit facility, borrowing capacity			$ 1,800,000,000
First Lien Credit Agreement \| Tranche B-2 Term Loan
Debt Instrument [Line Items]
Principal amount											$ 550,000,000
First Lien Credit Agreement \| Tranche B-3 Term Loan
Debt Instrument [Line Items]
Principal amount										$ 675,000,000
First Lien Credit Agreement \| Tranche B-2/3 Term Loan
Debt Instrument [Line Items]
Debt instrument, floor rate					0.00%
Principal at issuance (as a percent)					0.25%
First Lien Credit Agreement \| Tranche B-2/3 Term Loan \| SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)					3.50%
First Lien Credit Agreement \| Tranche B-2/3 Term Loan \| ABR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)					2.50%
First Lien Credit Agreement \| Tranche B-4 Term Loan
Debt Instrument [Line Items]
Principal amount		$ 2,566,000,000
First Lien Credit Agreement \| Tranche B-5 Term Loan
Debt Instrument [Line Items]
Principal amount	$ 2,553,200,000
Principal at issuance (as a percent)	0.25%
First Lien Credit Agreement \| Tranche B-5 Term Loan \| SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)	2.50%
First Lien Credit Agreement \| Tranche B-5 Term Loan \| ABR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)	1.50%
Swingline Loans \| Revolving Credit Facility
Debt Instrument [Line Items]
Aggregate amount of outstanding					$ 50,000,000
Swingline Loans \| Revolving Credit Facility \| ABR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)		2.25%
LC Sublimit \| Revolving Credit Facility
Debt Instrument [Line Items]
Aggregate amount of outstanding					82,500,000
Second Lien Credit Agreement
Debt Instrument [Line Items]
Principal amount					$ 450,000,000
Debt instrument, floor rate					1.00%
Loss on extinguishment of debt				$ 12,700,000
Second Lien Credit Agreement \| SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)					8.50%
Second Lien Credit Agreement \| ABR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)					7.50%

Consolidated Statements of Comprehensive Loss - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2025

Dec. 31, 2024

Dec. 31, 2023

Statement of Comprehensive Income [Abstract]

Net income (loss)

$ 189,113

$ (20,521)

$ (156,835)

Other comprehensive loss, net of tax:

Foreign currency translation adjustments

206

(309)

131

Cash flow hedges:

Net change in fair value, net of tax

^[1]

3,198

15,826

14,948

Amounts reclassified to earnings, net of tax

^[2]

(11,513)

(26,643)

(23,727)

Total other comprehensive loss

(8,109)

(11,126)

(8,648)

Total comprehensive income (loss)

181,004

(31,647)

(165,483)

Comprehensive loss attributable to redeemable noncontrolling interests

(1,143)

(1,789)

(2,167)

Comprehensive loss attributable to noncontrolling interest

(410)

(670)

(65)

Comprehensive income (loss) attributable to BrightSpring Health Services, Inc. and subsidiaries

$ 182,557

$ (29,188)

$ (163,251)

[1]	The income tax effects of the net change in fair value were $(1,038), $(5,149), and $(4,591) for the years ended December 31, 2025, 2024, and 2023, respectively.
[2]	The income tax effects of amounts reclassified to earnings were $3,736, $8,646, and $7,683 for the years ended December 31, 2025, 2024, and 2023, respectively.

Fair Value - Summary of Financial Assets or Liabilities Recorded at Fair value on Recurring Basis (Details) - Fair Value Measurement Recurring - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Market Approach
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets	$ 1,181	$ 10,633
Market and Income Approach
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial liabilities	2,311	8,386
Level 2 \| Market Approach \| Interest Rate Swaps
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets	1,181	10,633
Financial liabilities	1,561
Level 3 \| Income Approach \| Contingent Consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial liabilities	$ 750	$ 8,386

Revenues (Tables)

12 Months Ended

Dec. 31, 2025

Revenue from Contract with Customer [Abstract]

Schedule of Revenue by Payor Type

The following tables set forth revenue by payor type (in millions):


	Pharmacy Solutions
	For the Years Ended December 31,
	2025					2024					2023
	Revenue		% of Revenue			Revenue		% of Revenue			Revenue		% of Revenue
Commercial insurance	$	3,114.6		24.1	%	$	2,360.0		23.4	%	$	1,657.7		21.6	%
Medicaid		1,093.2		8.5	%		829.1		8.2	%		656.1		8.5	%
Medicare Part A		572.8		4.4	%		546.4		5.4	%		549.3		7.1	%
Medicare Part B		76.4		0.6	%		70.3		0.7	%		61.2		0.8	%
Medicare Part C		2,277.5		17.6	%		1,547.1		15.4	%		1,384.3		18.0	%
Medicare Part D		4,097.8		31.7	%		3,202.0		31.8	%		2,031.9		26.4	%
Private & other		213.5		1.8	%		199.4		2.0	%		182.0		2.4	%
	$	11,445.8		88.7	%	$	8,754.3		86.9	%	$	6,522.5		84.8	%


	Provider Services
	For the Years Ended December 31,
	2025					2024					2023
	Revenue		% of Revenue			Revenue		% of Revenue			Revenue		% of Revenue
Commercial insurance	$	188.7		1.5	%	$	168.1		1.7	%	$	152.5		2.0	%
Medicaid		402.0		3.1	%		337.4		3.3	%		323.0		4.2	%
Medicare Part A		521.5		4.0	%		453.2		4.5	%		409.3		5.3	%
Medicare Part B		6.4		0.0	%		25.6		0.3	%		21.6		0.3	%
Medicare Part C		135.6		1.1	%		117.9		1.2	%		66.1		0.9	%
Private & other		210.6		1.6	%		215.7		2.1	%		196.0		2.5	%
	$	1,464.8		11.3	%	$	1,317.9		13.1	%	$	1,168.5		15.2	%


	Consolidated
	For the Years Ended December 31,
	2025					2024					2023
	Revenue		% of Revenue			Revenue		% of Revenue			Revenue		% of Revenue
Commercial insurance	$	3,303.3		25.6	%	$	2,528.1		25.1	%	$	1,810.2		23.6	%
Medicaid		1,495.2		11.6	%		1,166.5		11.5	%		979.1		12.7	%
Medicare Part A		1,094.3		8.4	%		999.6		9.9	%		958.6		12.4	%
Medicare Part B		82.8		0.6	%		95.9		1.0	%		82.8		1.1	%
Medicare Part C		2,413.1		18.7	%		1,665.0		16.6	%		1,450.4		18.9	%
Medicare Part D		4,097.8		31.7	%		3,202.0		31.8	%		2,031.9		26.4	%
Private & other		424.1		3.4	%		415.1		4.1	%		378.0		4.9	%
	$	12,910.6		100.0	%	$	10,072.2		100.0	%	$	7,691.0		100.0	%

Redeemable Noncontrolling Interests - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Redeemable Noncontrolling Interest [Line Items]
Ownership interest	50.00%
Purchase of remaining noncontrolling interest paid	$ 5,100	$ 2,316

Share-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2025

Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]

Summary of Share Based Compensation Expense

The Company recorded share-based compensation expense on the consolidated statements of operations for the periods indicated as follows (in thousands):


	For The Years Ended December 31,
	2025		2024		2023
Cost of goods	$	2,704	$	2,115	$	—
Cost of services	$	3,884	$	3,296	$	—
Selling, general, and administrative expense	$	52,577	$	55,925	$	3,780

Summary of RSU activity

The following table summarizes the RSU activity under the 2024 Incentive Plan for the period presented:


	Units			Weighted Average Grant Date Fair Value		Weighted Average Remaining Contractual Term (years)		Aggregate Intrinsic Value (in millions)
Outstanding RSUs at January 1, 2025		10,587,226		$	11.85		2.51	$	180.3
Granted		1,931,654			17.93
Forfeited		(1,364,458	)		11.64
Vested		(1,948,306	)		14.03
Outstanding RSUs at December 31, 2025		9,206,116		$	12.68		1.73	$	344.8

Summary of Weighted Average Assumptions Used to Estimate Fair Value of Options Granted

The following table summarizes the weighted average assumptions used to estimate the fair value of options granted during the periods presented:


	2025		2024		2023
Expected volatility (range)	40.0 - 42.0%		43.8 - 52.5%		35.0 - 50.0%
Risk free interest rate (range)	3.6 - 4.1%		3.9 - 4.1%		4.2 - 5.5%
Expected dividends		—		—		—
Average expected term (years)	6.0		6.0		0.5 - 7.5
Average fair value per share of time-based stock options based on the Black-Scholes-Merton model (dollars)	$	8.33	$	6.86	$	9.69
Average fair value per share of performance stock options based on the Monte Carlo simulation (dollars)		—		—	$	3.10
Weighted average fair value of options granted (in millions)	$	25.06	$	11.40	$	9.20

Time-Based Options

Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]

Summary of Stock Options

The following table summarizes the Time-Based Options stock incentive plan activity under the 2017 Stock Plan and the 2024 Incentive Plan for the period presented:


	Number of Shares			Weighted Average Exercise Price		Weighted Average Grant Date Fair Value (in millions)			Aggregate Intrinsic Value (in millions)		Weighted Average Remaining Contractual Term (years)
Outstanding options at January 1, 2025		8,278,818		$	9.98	$	35.5		$	64.2		6.1
Granted		3,009,601			17.70		24.9
Forfeited, repurchased or expired		(406,848	)		13.94		(2.6	)
Exercised		(1,010,014	)		8.40		(3.5	)
Outstanding options at December 31, 2025		9,871,557		$	12.35	$	54.3		$	247.8		6.4

Exercisable options at December 31, 2025		6,065,430		$	9.52	$	23.70		$	168.4		4.8

Tier I and II Performance Option

Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]

Summary of Stock Options

The following table summarizes the Tier I and II Performance Option stock incentive plan activity under the 2017 Stock Plan for the period presented:


	Number of Shares			Weighted Average Exercise Price		Weighted Average Grant Date Fair Value (in millions)			Aggregate Intrinsic Value (in millions)		Weighted Average Remaining Contractual Term (years)
Outstanding options at January 1, 2025		6,656,999		$	7.82	$	13.8		$	63.9		5.0
Granted		—			—		—
Forfeited, repurchased or expired		(366,842	)		12.21		(1.0	)
Exercised		(2,340,254	)		7.07		(4.6	)
Outstanding options at December 31, 2025		3,949,903		$	7.86	$	8.2		$	116.9		4.0

Exercisable options at December 31, 2025		880,300		$	9.13	$	2.00		$	24.9		4.3

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Lease Arrangements - Summary of Lease Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Leases [Abstract]
Amortization of right-of-use assets	$ 3,906	$ 4,293	$ 3,356
Interest on lease liabilities	893	2,443	2,254
Operating lease cost	56,687	55,110	52,226
Short-term lease cost	6,001	4,952	5,069
Variable lease cost	8,270	8,344	8,179
Total lease costs	$ 75,757	$ 75,142	$ 71,084

Detail of Certain Balance Sheet Accounts - Schedule of Other Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Disclosure Text Block Supplement [Abstract]
Other investments	$ 7,481	$ 1,427
Insurance recoveries	7,251	7,564
Cloud computing	6,017	7,362
Deposits	5,722	6,733
Deferred compensation	4,702	3,777
Notes receivable	4,012	8,577
Deferred debt issuance costs	1,764	2,470
Interest rate swaps	1,181	0
Equity method investments	721	420
Other assets	861	798
Total other assets	$ 39,712	$ 39,128

Discontinued Operations - Summary of the Aggregate Carrying Amounts of Assets and Liabilities Held for Sale (Details) - Community Living Business - Discontinued Operations - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Current assets:
Cash and cash equivalents	$ 107	$ 299
Accounts receivable, net of allowance for credit losses	136,875	125,872
Inventories	3,294	4,007
Prepaid expenses and other current assets	2,717	1,269
Total current assets held for sale	142,993	131,447
Property and equipment, net of accumulated depreciation of $104,314 and $110,417 at December 31, 2025 and 2024, respectively	83,465	69,715
Goodwill	307,640	307,640
Intangible assets, net of accumulated amortization	216,192	216,258
Operating lease right-of-use assets, net	129,005	88,717
Deferred income taxes, net	0	287
Other assets	2,894	5,343
Total assets held for sale	882,189	819,407
Current liabilities:
Trade accounts payable	25,081	17,366
Accrued expenses	59,038	60,791
Current portion of obligations under operating leases	32,749	30,755
Current portion of obligations under financing leases	7,691	8,651
Total current liabilities held for sale	124,559	117,563
Obligations under operating leases, net of current portion	57,771	58,147
Obligations under financing leases, net of current portion	12,766	18,461
Deferred income taxes, net	390	0
Long-term liabilities	508	569
Total liabilities held for sale	$ 195,994	$ 194,740

Income Taxes - Summary of Net Cash Paid for Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Income Tax Paid, by Individual Jurisdiction [Line Items]
Federal	$ 18,431	$ 19,347	$ 27,297
Aggregated state and local jurisdictions	8,449	4,156	10,202
Foreign	90	40	0
Net cash paid for income taxes	$ 26,970	24,953	37,499
Virginia
Income Tax Paid, by Individual Jurisdiction [Line Items]
Aggregated state and local jurisdictions		$ 1,410	$ 0

Consolidated Statements of Shareholders' Equity (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Net loss excluding allocable redeemable noncontrolling interests	$ (1,143)	$ (1,789)	$ (2,167)
Net of underwriting discounts and commissions	9,100
Initial Public Offering
Payments for underwriting discounts and commissions tax benefit	5,300
Net of underwriting discounts and commissions	$ 36,800

Acquisitions - Schedule of Consideration Paid for Acquisitions and Estimated Fair Value of Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands		1 Months Ended	12 Months Ended
	Sep. 01, 2024	Dec. 31, 2025	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Business Combination [Line Items]
Goodwill		$ 2,545,673	$ 2,545,673	$ 2,363,884	$ 2,300,772
Amedisys and LHC Branches Acquisition
Business Combination [Line Items]
Accounts receivable		22,880	22,880
Prepaid expenses and other current assets		32	32
Property and equipment		5,580	5,580
Goodwill		175,042	175,042
Intangible assets		62,897	62,897
Operating lease right-of-use assets		12,604	12,604
Other assets		96	96
Trade accounts payable		730	730
Accrued expenses		10,631	10,631
Current portion of obligations under operating leases		4,177	4,177
Current portion of obligations under financing leases		1,746	1,746
Obligations under operating leases, net of current portion		8,427	8,427
Obligations under financing leases, net of current portion		3,570	3,570
Long-term liabilities		2,773	2,773
Redeemable noncontrolling interests		8,639	8,639
Noncontrolling interests		(21)	(21)
Aggregate purchase price, net of cash acquired		$ 238,459	$ 246,400
Haven Hospice, Inc.
Business Combination [Line Items]
Inventories	$ 45
Property and equipment	495
Goodwill	45,614
Intangible assets	19,860
Operating lease right-of-use assets	7,157
Trade accounts payable	1,264
Current portion of obligations under operating leases	2,235
Obligations under operating leases, net of current portion	4,922
Aggregate purchase price, net of cash acquired	$ 64,750
2024 Acquisitions
Business Combination [Line Items]
Aggregate purchase price, net of cash acquired				110,600
Pharmacy Solutions and Provider Services Segments
Business Combination [Line Items]
Accounts receivable				3,749
Inventories				1,234
Prepaid expenses and other current assets				174
Property and equipment				398
Goodwill				17,721
Intangible assets				31,233
Operating lease right-of-use assets				364
Other assets				1,438
Trade accounts payable				650
Accrued expenses				7,657
Current portion of obligations under operating leases				56
Current portion of obligations under financing leases				53
Obligations under operating leases, net of current portion				308
Obligations under financing leases, net of current portion				8
Deferred income taxes, net				1,686
Aggregate purchase price, net of cash acquired				$ 45,893

Debt and Derivatives

12 Months Ended

Dec. 31, 2025

Debt Disclosure [Abstract]

Debt and Derivatives

6. Debt and Derivatives

The table below summarizes the total outstanding debt of the Company (in thousands):


	December 31, 2025					December 31, 2024
	Rate			Amount		Rate			Amount
First Lien Incremental Term Loan Tranche B-5 - payable to lenders at SOFR plus applicable margin		6.22	%	$	2,521,255		6.86	%	$	2,546,787
Revolving Credit Loans - payable to lenders at SOFR plus applicable margin		6.47	%		—		7.61	%		—
Swingline/Base Rate - payable to lenders at ABR plus applicable margin		8.50	%		—		9.75	%		63,300
Amortizing Notes (1)					31,360					53,804
Notes payable and other					17,129					19,428
Total debt					2,569,744					2,683,319
Less: debt issuance costs, net					62,200					72,736
Total debt, net of debt issuance costs					2,507,544					2,610,583
Less: current portion of long-term debt					52,340					48,725
Total long-term debt, net of current portion				$	2,455,204				$	2,561,858

(1) See Note 7 for discussion of Amortizing Notes.

As of December 31, 2025, maturities of long-term debt for the next five years and thereafter are as follows (in thousands):


2026	$	52,340
2027		32,135
2028		40,549
2029		25,549
2030		25,549
Thereafter		2,393,622
	$	2,569,744

See Note 13 for maturities of obligations under financing leases.

The following discussion summarizes the debt agreements and related extinguishments and modifications for the years ended December 31, 2025 and 2024.

Obligations under the First Lien Facility is guaranteed by Phoenix Guarantor, Inc., a subsidiary of the Company, and each of its current and future direct and indirect subsidiaries other than (among others) (i) foreign subsidiaries, (ii) unrestricted subsidiaries, (iii) non-wholly owned subsidiaries, (iv) certain receivables financing subsidiaries, (v) certain immaterial subsidiaries and (vi) certain holding companies of foreign subsidiaries, and are secured by a first lien on substantially all of their assets, including capital stock of subsidiaries.

The current credit facilities described below contain customary negative covenants, including, but not limited to, restrictions on the Company and its restricted subsidiaries’ ability to merge and consolidate with other companies, incur indebtedness, grant liens or security interests on assets, make acquisitions, loans, advances or investments, pay dividends, sell or otherwise transfer assets, prepay or modify terms of certain junior indebtedness, enter into transactions with affiliates, or change their lines of business or fiscal year. In addition, the terms of the credit facilities will not permit the consolidated First Lien secured debt to consolidated earnings before interest, taxes, depreciation, and amortization (“EBITDA”) to be greater than 6.90 to 1.00, which shall be tested as of the end of the most recent quarter at any time when the aggregate Revolving Credit Facility loans exceed 35% of the total revolving credit commitments.

We are required to disclose the fair value of financial instruments for which it is practicable to estimate the value, even though these instruments are not recognized at fair value in the consolidated balance sheets. The following table presents the estimated fair values of the Company’s debt obligations as of December 31, 2025 (in millions):


			Fair Value at Reporting Date Using
Financial Instrument	Carrying Value as of December 31, 2025		Markets for Identical Item (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
First Lien Term Loan	$	2,521,255	$	—	$	2,540,164	$	—
Amortizing Notes		31,360		—		31,948		—
Total debt instruments	$	2,552,615	$	—	$	2,572,112	$	—

First Lien Credit Agreement

On March 5, 2019, the Company entered into a First Lien Credit Agreement (the “First Lien”), with Morgan Stanley Senior Funding, Inc., as the Administrative Agent and the Collateral Agent. The First Lien originally consisted of a principal amount of $1,650.0 million. In 2019, an additional delayed draw of $150.0 million was made on the First Lien, resulting in a gross borrowing of $1,800.0 million (“Tranche B-1”). Borrowings of Tranche B-1 Term Loans (as defined in the First Lien) under the First Lien bore interest at a rate equal to, at our option, (a) Secured Overnight Financing Rate (“SOFR”) (with a floor of 0.00%) plus 3.25% or (b) Alternate Base Rate (“ABR”) plus 2.25%. Principal payments were due on the last business day of each quarter, commencing in September 2019 at 0.25% of the aggregate principal of the original loan amount, with a balloon payment due in March 2026.

The First Lien, as amended in 2020, established a Tranche B-2 Term Loan (“Tranche B-2”) in an aggregate principal amount equal to $550.0 million. The First Lien, as amended in 2021, established a Tranche B-3 Term Loan (“Tranche B-3”) in an aggregate principal amount equal to $675.0 million. Borrowings under Tranche B-2 and Tranche B-3, bore interest at a rate equal to, at our option, (a) SOFR (with a floor of 0.00%) plus 3.50% or (b) ABR plus 2.50%. Principal payments were due on the last business day of each fiscal quarter, commencing in June 2021 at 0.25% of the aggregate principal of the original loan amount, with a balloon payment due in March 2026.

On February 21, 2024, we used a portion of the net proceeds received from the IPO Offerings to repay $343.3 million of the borrowings under the First Lien, and amended the First Lien to establish a new Tranche B-4 Term Loan (“Tranche B-4”) in an aggregate principal amount of $2,566.0 million. The proceeds from Tranche B-4 borrowings were used to refinance the equivalent amount of the remaining First Lien Tranches B-1, B-2, and B-3 borrowings at a rate equal to SOFR plus 3.25% with a maturity date of February 21, 2031. The transaction was accounted for as a debt modification. Principal payments were due on the last business day of each quarter, which commenced in the second fiscal quarter of 2024 and equated to 0.25% of the principal at issuance, with a balloon payment due in February 2031.

On December 11, 2024, we amended the First Lien to refinance Tranche B-4 by establishing a Tranche B-5 Term Loan (“Tranche B-5”) in an aggregate principal amount of $2,553.2 million at a rate equal to, at our option, (a) SOFR plus 2.50% or (b) ABR plus 1.50% with a maturity date of February 21, 2031. The non-cash transaction was accounted for as a debt modification. Principal payments are due on the last business day of each quarter, which commenced in the first fiscal quarter of 2025 and equate to 0.25% of the principal at issuance, with a balloon payment due in February 2031.

Revolving Credit Facility

The First Lien also extends credit in the form of Revolving Credit Facility with a borrowing capacity of $475.0 million (the “Revolver”), of which up to $50.0 million is available as swingline loans and up to $82.5 million is available as letters of credit (the “LC Sublimit”). The Revolver will mature on June 30, 2028. In connection with the First Lien modification on February 21, 2024, borrowings of the Revolver bear interest at a rate equal to SOFR (with a floor of 0.00%) plus 3.25% for the Revolving Credit Loans or ABR plus 2.25% for the Swingline Loans. As of December 31, 2025, the Company had $475.0 million of borrowing capacity available under the Revolver as there were no borrowings under the Revolver or letters of credit outstanding. As of December 31, 2024, the Company had $63.3 million of borrowings outstanding under the Revolver and no letters of credit reducing the available borrowing capacity to approximately $411.7 million.

The Company’s First Lien also provides for an additional letter of credit commitments (the “LC Facility”), which are not subject to the LC Sublimit and do not reduce the Revolver borrowing capacity. On September 17, 2024, the Company amended the First Lien to increase the LC Facility from $55.0 million to $65.0 million. As of December 31, 2025 and 2024, there were $62.8 million and $61.8 million of letters of credit outstanding under the LC Facility, respectively, resulting in an available borrowing capacity of $2.2 million and $3.2 million, respectively.

Second Lien Credit Agreement

The Company’s amended and restated Second Lien Credit Agreement (the “Second Lien Facility”), with certain Lenders and Wilmington Trust, National Association, as the Administrative Agent and the Collateral Agent consisted of a principal amount of $450.0 million.

Borrowings under the Second Lien Facility term were subordinated to the First Lien and bore interest at a rate equal to, at our option, (a) SOFR (with a floor of 1.00%) plus 8.50% or (b) ABR plus 7.50%. The aggregate principal was due with a balloon payment in March 2027.

On January 30, 2024, we used a portion of the net proceeds received from the IPO Offerings to repay all outstanding borrowings under the Second Lien Facility. No remaining obligation exists related to the Second Lien Facility. This transaction was accounted for as a debt extinguishment and the Company incurred a loss on extinguishment of debt of $12.7 million related to the write-off of unamortized debt issuance costs during the first fiscal quarter of 2024.

Derivative Financial Instruments

To manage fluctuations in cash flows resulting from changes in the variable rates, the Company entered into receive-variable, pay-fixed interest rate swap agreements. Taken together with the related debt, these swaps create the economic equivalent of fixed-rate debt, up to the notional amount of the hedged debt. By using a derivative instrument to hedge exposures to changes in interest rates, we expose ourselves to credit risk. Credit risk is the failure of the counterparty to perform under the terms of the derivative contract. When the fair value of a derivative contract is positive, the counterparty owes the Company, which creates credit risk for the Company. When the fair value of a derivative contract is negative, the Company owes the counterparty and, therefore, the Company is not exposed to the counterparty’s credit risk in those circumstances. The Company mitigates counterparty credit risk in derivative instruments by entering into transactions with high-quality counterparties. The derivative instruments entered into by the Company do not contain credit-risk-related contingent features.

The following table summarizes our interest rate swaps designated as cash flow hedges (in millions):


	Notional Amount as of
Financial Institution	December 31, 2025		December 31, 2024		Effective Dates	Fixed Rates
Credit Suisse	$	—	$	500	3-year period ending September 30, 2025		3.41650	%
Morgan Stanley		—		1,050	3-year period ending September 30, 2025		3.42000	%
Credit Agricole Corporate and Investment Bank		—		450	3-year period ending September 30, 2025		3.52410	%
Matured contracts	$	—	$	2,000

Credit Agricole Corporate and Investment Bank	$	500	$	—	1-year period ending September 30, 2026		3.72500	%
Mizuho Capital Markets		500		—	1-year period ending September 30, 2026		3.61121	%
Credit Agricole Corporate and Investment Bank		250		—	3-year period ending September 30, 2028		3.33150	%
Morgan Stanley		250		—	3-year period ending September 30, 2028		3.17700	%
Existing contracts	$	1,500	$	—

Mizuho Capital Markets	$	500	$	—	2-year period ending September 30, 2028		3.20220	%
Forward starting contracts (1)	$	500	$	—

(1)

During the fourth fiscal quarter of 2025, we entered into a forward starting interest rate swap agreement, with a $500 million notional amount, to hedge the cash flow risk of variability in interest payment on our variable rate borrowings. The effective date of the forward starting interest rate swap agreement is September 30, 2026. As of December 31, 2025, this contract meets the criteria of a cash flow hedge.

The net fair value of the cash flow hedges as of December 31, 2025 and 2024 was $0.4 million liability and $10.6 million asset, respectively, and is reflected in prepaid expenses and other current assets, other assets, accrued expenses, and long-term liabilities in the consolidated balance sheets.

Amounts reported in AOCI related to derivatives will be reclassified to interest expense as interest payments are made on the Company’s variable-rate debt. Interest received, including payments made or received under the cash flow hedges, was $15.2 million, $35.3 million, and $31.4 million for the years ended December 31, 2025, 2024, and 2023, respectively. During the next twelve months, the Company expects approximately $0.8 million of losses will be reclassified into pre-tax earnings out of AOCI.

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Total revenues	$ 12,910,564	$ 10,072,214	$ 7,691,016
Cost of goods	10,507,431	8,008,501	5,840,716
Cost of services	885,356	797,286	711,304
Gross profit	1,517,777	1,266,427	1,138,996
Selling, general, and administrative expenses	1,222,525	1,158,473	1,080,871
Operating income	295,252	107,954	58,125
Loss on extinguishment of debt		12,726
Interest expense, net	157,311	190,546	271,899
Income (loss) from continuing operations before income taxes	137,941	(95,318)	(213,774)
Income tax expense (benefit)	33,145	(26,387)	(31,508)
Net income (loss) from continuing operations	104,796	(68,931)	(182,266)
Income from discontinued operations, net of income taxes	84,317	48,410	25,431
Net income (loss)	189,113	(20,521)	(156,835)
Net loss attributable to noncontrolling interests included in continuing operations	(1,553)	(2,459)	(2,232)
Net income (loss) attributable to BrightSpring Health Services, Inc. and subsidiaries	$ 190,666	$ (18,062)	$ (154,603)
Basic income (loss) per share attributable to common shareholders:
Continuing operations	$ 0.53	$ (0.34)	$ (1.53)
Discontinued operations	0.41	0.25	0.22
Net income (loss) per share	0.94	(0.09)	(1.31)
Diluted income (loss) per share attributable to common shareholders:
Continuing operations	0.48	(0.34)	(1.53)
Discontinued operations	0.39	0.25	0.22
Net income (loss) per share	$ 0.87	$ (0.09)	$ (1.31)
Weighted average shares outstanding:
Basic	202,564	192,997	117,868
Diluted	219,774	192,997	117,868
Products
Total revenues	$ 11,445,777	$ 8,754,282	$ 6,522,450
Services
Total revenues	$ 1,464,787	$ 1,317,932	$ 1,168,566

Debt and Derivatives (Tables)

12 Months Ended

Dec. 31, 2025

Debt Disclosure [Abstract]

Schedule of Total Outstanding Debt

The table below summarizes the total outstanding debt of the Company (in thousands):


	December 31, 2025					December 31, 2024
	Rate			Amount		Rate			Amount
First Lien Incremental Term Loan Tranche B-5 - payable to lenders at SOFR plus applicable margin		6.22	%	$	2,521,255		6.86	%	$	2,546,787
Revolving Credit Loans - payable to lenders at SOFR plus applicable margin		6.47	%		—		7.61	%		—
Swingline/Base Rate - payable to lenders at ABR plus applicable margin		8.50	%		—		9.75	%		63,300
Amortizing Notes (1)					31,360					53,804
Notes payable and other					17,129					19,428
Total debt					2,569,744					2,683,319
Less: debt issuance costs, net					62,200					72,736
Total debt, net of debt issuance costs					2,507,544					2,610,583
Less: current portion of long-term debt					52,340					48,725
Total long-term debt, net of current portion				$	2,455,204				$	2,561,858

(1) See Note 7 for discussion of Amortizing Notes.

Schedule of Maturities of Long-Term Debt

As of December 31, 2025, maturities of long-term debt for the next five years and thereafter are as follows (in thousands):


2026	$	52,340
2027		32,135
2028		40,549
2029		25,549
2030		25,549
Thereafter		2,393,622
	$	2,569,744

Summary of Estimated Fair Values of Debt Obligations

The following table presents the estimated fair values of the Company’s debt obligations as of December 31, 2025 (in millions):


			Fair Value at Reporting Date Using
Financial Instrument	Carrying Value as of December 31, 2025		Markets for Identical Item (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
First Lien Term Loan	$	2,521,255	$	—	$	2,540,164	$	—
Amortizing Notes		31,360		—		31,948		—
Total debt instruments	$	2,552,615	$	—	$	2,572,112	$	—

Schedule of Interest Rate Swap with Notional Value


	Notional Amount as of
Financial Institution	December 31, 2025		December 31, 2024		Effective Dates	Fixed Rates
Credit Suisse	$	—	$	500	3-year period ending September 30, 2025		3.41650	%
Morgan Stanley		—		1,050	3-year period ending September 30, 2025		3.42000	%
Credit Agricole Corporate and Investment Bank		—		450	3-year period ending September 30, 2025		3.52410	%
Matured contracts	$	—	$	2,000

Credit Agricole Corporate and Investment Bank	$	500	$	—	1-year period ending September 30, 2026		3.72500	%
Mizuho Capital Markets		500		—	1-year period ending September 30, 2026		3.61121	%
Credit Agricole Corporate and Investment Bank		250		—	3-year period ending September 30, 2028		3.33150	%
Morgan Stanley		250		—	3-year period ending September 30, 2028		3.17700	%
Existing contracts	$	1,500	$	—

Mizuho Capital Markets	$	500	$	—	2-year period ending September 30, 2028		3.20220	%
Forward starting contracts (1)	$	500	$	—

(1)

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

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+ Details

Discontinued Operations

12 Months Ended

Dec. 31, 2025

Discontinued Operations and Disposal Groups [Abstract]

Discontinued Operations

2. Discontinued Operations

On January 17, 2025, BrightSpring entered into a definitive agreement to sell its Community Living business to National Mentor Holdings, Inc. (the “Purchaser”), for $835.0 million in cash upon closing, subject to certain post-closing adjustments. We entered into the transaction in order to streamline our service offerings and further focus on the senior and specialty populations. The transaction is currently expected to close in the first fiscal quarter of 2026, subject to receipt of customary regulatory approvals and other closing conditions.

The Company has determined the divestiture of the Community Living business represents a strategic shift that will have a major effect on its business and has concluded the criteria for classification as discontinued operations were met during the first fiscal quarter of 2025. Accordingly, the Community Living business is reported as discontinued operations in accordance with ASC 205-20, Discontinued Operations. The related assets and liabilities of the Community Living business are classified as assets and liabilities held for sale in the accompanying consolidated balance sheets and the results of operations from the Community Living business are classified as discontinued operations in the consolidated statements of operations. Applicable amounts in prior years have been retrospectively revised and recast to conform to this discontinued operations presentation. The Community Living business was historically presented as a part of the Provider Services reportable segment.

In accordance with ASC 205-20, Allocation of Interest to Discontinued Operations, the Company elected to allocate interest expense to discontinued operations for the Company’s debt that is not directly attributed to the Community Living business. Interest expense was allocated based on a ratio of net assets held for sale to the sum of consolidated net assets and consolidated debt. In addition, upon closing of the divestiture, we will enter into a transition services agreement (“TSA”) with the Purchaser to support the Purchaser's post-closing operations of the Community Living business by providing the Purchaser with certain transition services in exchange for service fees in the form of both fixed-price and pass through costs. Transition services will primarily include human resources, IT, facilities management, and compliance.

The financial results of the Community Living business are presented as income from discontinued operations on our consolidated statements of operations. The following table presents the financial results of the Community Living business (in thousands):


	For the Years Ended December 31,
	2025		2024		2023
Services revenue	$	1,234,403	$	1,194,258	$	1,135,159
Cost of services		840,172		872,250		840,361
Gross profit		394,231		322,008		294,798
Selling, general, and administrative expenses		254,753		223,588		205,743
Operating income of discontinued operations		139,478		98,420		89,055
Interest expense, net		29,917		37,840		52,694
Income from discontinued operations before income taxes		109,561		60,580		36,361
Income tax expense from discontinued operations		25,244		12,170		10,930
Income from discontinued operations, net of income taxes	$	84,317	$	48,410	$	25,431

The following table presents the aggregate carrying amounts of assets and liabilities held for sale for the Community Living business in the consolidated balance sheets (in thousands):


	December 31, 2025		December 31, 2024
Assets
Current assets:
Cash and cash equivalents	$	107	$	299
Accounts receivable, net of allowance for credit losses		136,875		125,872
Inventories		3,294		4,007
Prepaid expenses and other current assets		2,717		1,269
Total current assets held for sale		142,993		131,447
Property and equipment, net of accumulated depreciation of $104,314 and $110,417 at December 31, 2025 and 2024, respectively		83,465		69,715
Goodwill		307,640		307,640
Intangible assets, net of accumulated amortization		216,192		216,258
Operating lease right-of-use assets, net		129,005		88,717
Deferred income taxes, net		—		287
Other assets		2,894		5,343
Total assets held for sale	$	882,189	$	819,407
Liabilities
Current liabilities:
Trade accounts payable	$	25,081	$	17,366
Accrued expenses		59,038		60,791
Current portion of obligations under operating leases		32,749		30,755
Current portion of obligations under financing leases		7,691		8,651
Total current liabilities held for sale		124,559		117,563
Obligations under operating leases, net of current portion		57,771		58,147
Obligations under financing leases, net of current portion		12,766		18,461
Deferred income taxes, net		390		—
Long-term liabilities		508		569
Total liabilities held for sale	$	195,994	$	194,740

In accordance with ASC 205-20, all assets and liabilities held for sale are reported as current on the consolidated balance sheet at December 31, 2025 as the Community Living transaction is expected to close within one-year of the balance sheet date. The presentation of assets and liabilities held for sale on the consolidated balance sheet at December 31, 2024 are reported as current and noncurrent, consistent with the conclusion in the period, as the transaction did not meet the requirements of held for sale at that point in time.

The following table presents the significant non-cash items and purchases of property and equipment for the discontinued operations that are included in the accompanying consolidated statements of cash flows (in thousands):


	For the Years Ended December 31,
	2025		2024		2023
Cash flows from operating activities of discontinued operations:
Depreciation and amortization	$	1,329	$	42,338	$	41,779
Share-based compensation		10,934		7,838		137
Impairment of long-lived assets		—		6,238		8,134

Cash flows from investing activities of discontinued operations:
Purchases of property and equipment		12,313		10,429		11,983

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2025

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

5. Goodwill and Intangible Assets

In 2025, 2024, and 2023, the Company performed a quantitative assessment of all reporting units as of October 1. We utilized a combination of the discounted cash flow analysis or “income approach” (50%) and the “market approach” (50%).

Our 2025, 2024, and 2023 goodwill impairment analyses concluded that the fair values of all reporting units were in excess of their carrying amounts. Subsequent to completing our goodwill impairment tests, no further indicators of impairment were identified. Based on these analyses, we recorded no goodwill impairment for the years ended December 31, 2025, 2024, and 2023.

The determination of whether the carrying value of the reporting unit exceeds its fair value involves a high degree of estimation and can be affected by a number of industry and company-specific risk factors that are subject to change over time. If actual performance does not achieve the projections, or if the assumptions used change in the future, we may be required to recognize additional impairment charges in future periods.

A summary of changes to goodwill is as follows (in thousands):


	Goodwill
	Pharmacy Solutions		Provider Services			Total
Goodwill at January 1, 2024*	$	833,989	$	1,466,783		$	2,300,772
Goodwill added through acquisitions		7,063		56,144			63,207
Measurement period adjustments		—		237			237
Foreign currency adjustments		—		(332	)		(332	)
Goodwill at December 31, 2024*	$	841,052	$	1,522,832		$	2,363,884
Goodwill added through acquisitions		—		181,472			181,472
Measurement period adjustments		—		128			128
Foreign currency adjustments		—		189			189
Goodwill at December 31, 2025*	$	841,052	$	1,704,621		$	2,545,673

* For the periods presented, the carrying amount of goodwill is presented net of accumulated impairment losses of $40.9 million, which were incurred in fiscal year 2022.

Intangible assets are as follows (in thousands):


	December 31, 2025						December 31, 2024
	Gross		Accumulated Amortization		Net Carrying Value		Gross		Accumulated Amortization		Net Carrying Value		Life (Years)
Customer relationships	$	502,160	$	356,146	$	146,014	$	542,137	$	335,647	$	206,490	5-20
Trade names		318,768		154,601		164,167		332,977		140,020		192,957	2-20
Licenses		67,395		18,886		48,509		68,425		17,528		50,897	10-20
Doctor/payor network		5,650		4,987		663		12,730		10,965		1,765	5-8
Covenants not to compete		6,654		4,717		1,937		8,790		5,886		2,904	2-7
Other intangible assets		10,940		7,925		3,015		10,940		6,362		4,578	5-7
Total definite-lived assets	$	911,567	$	547,262	$	364,305	$	975,999	$	516,408	$	459,591
Licenses		193,250		—		193,250		135,633		—		135,633	Indefinite
Total intangible assets	$	1,104,817	$	547,262	$	557,555	$	1,111,632	$	516,408	$	595,224

Amortization expense for the years ended December 31, 2025, 2024, and 2023 was $91.1 million, $95.3 million, and $103.3 million, respectively.

As of December 31, 2025, total estimated amortization expense for the Company’s definite-lived intangible assets for the next five years and thereafter is as follows (in thousands):


2026	$	79,888
2027		46,935
2028		39,876
2029		34,000
2030		33,108
Thereafter		130,498
	$	364,305

Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2025

Accounting Policies [Abstract]

Principles of Consolidation

Basis of Presentation

The accompanying consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”).

Use of Estimates

Revenue Recognition

Pharmacy Solutions

Provider Services

Contractual Allowances

Cost of Goods and Cost of Services

Supplier Rebates

Cash and Cash Equivalents

Accounts Receivable

Inventories

Investments

Goodwill and Intangible Assets

Debt Issuance Costs

Deferred Offering Costs

Derivative Financial Instruments

The Company has interest rate swap agreements to manage its interest rate exposure. The Company does not use financial instruments for trading or other speculative purposes.

Income Taxes

Legal Contingencies

Insurance Losses

Fair Value of Financial Instruments


(a) Level 1	Quoted prices in active markets for identical assets or liabilities.
(b) Level 2	Inputs other than quoted prices included within Level 1 that are observable for the asset or liability.
(c) Level 3	Unobservable inputs used in valuations in which there is little market activity for the asset or liability at the measurement date.

Leases

Property and Equipment

Segments

Share-Based Compensation

Foreign Currency Translation

Recently Adopted Accounting Standards

In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. This ASU requires the following disclosures on an annual basis:

•

Qualitative disclosure of the nature and effect of significant reconciling items by specific categories and individual jurisdictions; and

•

Income taxes paid (net of refunds received), broken out between federal, state/local and foreign, and amounts paid to an individual jurisdiction when 5% or more of the total income taxes paid.

In November 2023, the FASB issued Accounting Standards Update (“ASU”) 2023-07, Segment Reporting. This ASU requires the following disclosures on an annual and interim basis:

•

Significant segment expenses that are regularly provided to the CODM and included with each reported measure of segment profit/loss;

•

Other segment items by reportable segment, consisting of differences between segment revenue and segment profit/loss not already disclosed above;

•

Other information by reportable segment, including total assets, depreciation and amortization, and capital expenditures; and

•

The title of the CODM and an explanation of how the CODM uses the reported measures of segment profit/loss in assessing segment performance and deciding how to allocate resources.

Recently Issued Accounting Standards

Detail of Certain Balance Sheet Accounts - Schedule of Long-Term Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Disclosure Text Block Supplement [Abstract]
Workers compensation insurance reserves	$ 25,369	$ 25,360
General and professional liability insurance reserves	25,032	21,182
Automobile insurance reserves	9,849	9,034
Deferred compensation	4,702	3,777
Contingent consideration	750	5,250
Interest rate swaps	156
Other	707	6,587
Total long-term liabilities	$ 66,565	$ 71,190

Lease Arrangements

12 Months Ended

Dec. 31, 2025

Leases [Abstract]

Lease Arrangements

13. Lease Arrangements

The Company's population of leases includes provider and pharmacy locations, office space, and equipment, which have expiration dates through 2034. Real estate and office space leases generally contain renewal options for periods ranging from 3 to 10 years. The Company is not reasonably certain to exercise the renewal options on most provider real estate, office space, and equipment leases, and, as a result, these options are excluded from the determination of the lease term, and any potential payments related to such renewal periods are not included in the measurement of lease liabilities and right-of-use assets. Generally, for pharmacy real estate leases, the initial lease term is equivalent to the first term plus one renewal option.

Lease expense consists of operating and finance lease costs, short-term lease costs, and variable lease costs, which primarily include common area maintenance, real estate taxes, and insurance for the Company’s real estate leases.

Lease expense is summarized as follows (in thousands):


	For the Years Ended December 31,
	2025		2024		2023
Finance leases:
Amortization of right-of-use assets	$	3,906	$	4,293	$	3,356
Interest on lease liabilities		893		2,443		2,254
Operating leases:
Operating lease cost		56,687		55,110		52,226
Short-term lease cost		6,001		4,952		5,069
Variable lease cost		8,270		8,344		8,179
Total lease costs	$	75,757	$	75,142	$	71,084

Future minimum lease payments of our leases as of December 31, 2025 are as follows (in thousands):


Fiscal Year	Finance Lease Costs		Operating Lease Costs
2026	$	7,833	$	53,793
2027		6,788		49,308
2028		5,193		38,989
2029		2,825		26,438
2030		461		18,491
Thereafter		50		22,491
Total future minimum lease payments	$	23,150	$	209,510
Less: imputed interest		1,812		31,154
Total present value of lease liabilities	$	21,338	$	178,356

Supplemental Cash Flow & Other Information

Supplemental cash flow information related to leases are summarized as follows (dollars in thousands):


	For the Years Ended December 31,
	2025			2024			2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from finance leases	$	(893	)	$	(2,443	)	$	(2,254	)
Financing cash flows from finance leases		(4,624	)		(4,220	)		(4,082	)
Operating cash flows from operating leases		(58,206	)		(55,269	)		(51,621	)
Right-of-use assets obtained in exchange for new finance lease liabilities		16,977			3,171			3,726
Right-of-use assets obtained in exchange for new operating lease liabilities		57,097			38,718			35,555
Weighted-average remaining lease term (in years):
Finance leases		3.3			3.1			3.1
Operating leases		4.5			4.9			5.5
Weighted-average discount rate:
Finance leases		6.7	%		6.7	%		7.2	%
Operating leases		6.7	%		6.8	%		7.1	%

Share-Based Compensation - Summary of Weighted Average Assumptions Used to Estimate Fair Value of Options Granted (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Expected volatility (range), minimum	40.00%	43.80%	35.00%
Expected volatility (range), maximum	42.00%	52.50%	50.00%
Risk free interest rate (range), minimum	3.60%	3.90%	4.20%
Risk free interest rate (range), maximum	4.10%	4.10%	5.50%
Average expected term (years)	6 years	6 years
Weighted average fair value of options granted (in millions)	$ 25,060	$ 11,400	$ 9,200
Minimum
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Average expected term (years)			6 months
Maximum
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Average expected term (years)			7 years 6 months
Black-Scholes-Merton Model \| Time-Based Options
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Average fair value per share of stock options	$ 8.33	$ 6.86	$ 9.69
Monte Carlo Simulation \| Performance Stock Options
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Average fair value per share of stock options			$ 3.1

Revenues - Schedule of Revenue by Payor Type (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Disaggregation of Revenue [Line Items]
Revenues	$ 12,910,564	$ 10,072,214	$ 7,691,016
Commercial Insurance
Disaggregation of Revenue [Line Items]
Revenues	3,303,300	2,528,100	1,810,200
Medicaid
Disaggregation of Revenue [Line Items]
Revenues	1,495,200	1,166,500	979,100
Medicare Part A
Disaggregation of Revenue [Line Items]
Revenues	1,094,300	999,600	958,600
Medicare Part B
Disaggregation of Revenue [Line Items]
Revenues	82,800	95,900	82,800
Medicare Part C
Disaggregation of Revenue [Line Items]
Revenues	2,413,100	1,665,000	1,450,400
Medicare Part D
Disaggregation of Revenue [Line Items]
Revenues	4,097,800	3,202,000	2,031,900
Private and Other
Disaggregation of Revenue [Line Items]
Revenues	424,100	415,100	378,000
Pharmacy Solutions
Disaggregation of Revenue [Line Items]
Revenues	11,445,800	8,754,300	6,522,500
Pharmacy Solutions \| Commercial Insurance
Disaggregation of Revenue [Line Items]
Revenues	3,114,600	2,360,000	1,657,700
Pharmacy Solutions \| Medicaid
Disaggregation of Revenue [Line Items]
Revenues	1,093,200	829,100	656,100
Pharmacy Solutions \| Medicare Part A
Disaggregation of Revenue [Line Items]
Revenues	572,800	546,400	549,300
Pharmacy Solutions \| Medicare Part B
Disaggregation of Revenue [Line Items]
Revenues	76,400	70,300	61,200
Pharmacy Solutions \| Medicare Part C
Disaggregation of Revenue [Line Items]
Revenues	2,277,500	1,547,100	1,384,300
Pharmacy Solutions \| Medicare Part D
Disaggregation of Revenue [Line Items]
Revenues	4,097,800	3,202,000	2,031,900
Pharmacy Solutions \| Private and Other
Disaggregation of Revenue [Line Items]
Revenues	213,500	199,400	182,000
Provider Services
Disaggregation of Revenue [Line Items]
Revenues	1,464,800	1,317,900	1,168,500
Provider Services \| Commercial Insurance
Disaggregation of Revenue [Line Items]
Revenues	188,700	168,100	152,500
Provider Services \| Medicaid
Disaggregation of Revenue [Line Items]
Revenues	402,000	337,400	323,000
Provider Services \| Medicare Part A
Disaggregation of Revenue [Line Items]
Revenues	521,500	453,200	409,300
Provider Services \| Medicare Part B
Disaggregation of Revenue [Line Items]
Revenues	6,400	25,600	21,600
Provider Services \| Medicare Part C
Disaggregation of Revenue [Line Items]
Revenues	135,600	117,900	66,100
Provider Services \| Private and Other
Disaggregation of Revenue [Line Items]
Revenues	$ 210,600	$ 215,700	$ 196,000
Product Concentration Risk \| Revenue
Disaggregation of Revenue [Line Items]
% of Revenue	100.00%	100.00%	100.00%
Product Concentration Risk \| Revenue \| Commercial Insurance
Disaggregation of Revenue [Line Items]
% of Revenue	25.60%	25.10%	23.60%
Product Concentration Risk \| Revenue \| Medicaid
Disaggregation of Revenue [Line Items]
% of Revenue	11.60%	11.50%	12.70%
Product Concentration Risk \| Revenue \| Medicare Part A
Disaggregation of Revenue [Line Items]
% of Revenue	8.40%	9.90%	12.40%
Product Concentration Risk \| Revenue \| Medicare Part B
Disaggregation of Revenue [Line Items]
% of Revenue	0.60%	1.00%	1.10%
Product Concentration Risk \| Revenue \| Medicare Part C
Disaggregation of Revenue [Line Items]
% of Revenue	18.70%	16.60%	18.90%
Product Concentration Risk \| Revenue \| Medicare Part D
Disaggregation of Revenue [Line Items]
% of Revenue	31.70%	31.80%	26.40%
Product Concentration Risk \| Revenue \| Private and Other
Disaggregation of Revenue [Line Items]
% of Revenue	3.40%	4.10%	4.90%
Product Concentration Risk \| Revenue \| Pharmacy Solutions
Disaggregation of Revenue [Line Items]
% of Revenue	88.70%	86.90%	84.80%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Commercial Insurance
Disaggregation of Revenue [Line Items]
% of Revenue	24.10%	23.40%	21.60%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Medicaid
Disaggregation of Revenue [Line Items]
% of Revenue	8.50%	8.20%	8.50%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Medicare Part A
Disaggregation of Revenue [Line Items]
% of Revenue	4.40%	5.40%	7.10%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Medicare Part B
Disaggregation of Revenue [Line Items]
% of Revenue	0.60%	0.70%	0.80%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Medicare Part C
Disaggregation of Revenue [Line Items]
% of Revenue	17.60%	15.40%	18.00%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Medicare Part D
Disaggregation of Revenue [Line Items]
% of Revenue	31.70%	31.80%	26.40%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Private and Other
Disaggregation of Revenue [Line Items]
% of Revenue	1.80%	2.00%	2.40%
Product Concentration Risk \| Revenue \| Provider Services
Disaggregation of Revenue [Line Items]
% of Revenue	11.30%	13.10%	15.20%
Product Concentration Risk \| Revenue \| Provider Services \| Commercial Insurance
Disaggregation of Revenue [Line Items]
% of Revenue	1.50%	1.70%	2.00%
Product Concentration Risk \| Revenue \| Provider Services \| Medicaid
Disaggregation of Revenue [Line Items]
% of Revenue	3.10%	3.30%	4.20%
Product Concentration Risk \| Revenue \| Provider Services \| Medicare Part A
Disaggregation of Revenue [Line Items]
% of Revenue	4.00%	4.50%	5.30%
Product Concentration Risk \| Revenue \| Provider Services \| Medicare Part B
Disaggregation of Revenue [Line Items]
% of Revenue	0.00%	0.30%	0.30%
Product Concentration Risk \| Revenue \| Provider Services \| Medicare Part C
Disaggregation of Revenue [Line Items]
% of Revenue	1.10%	1.20%	0.90%
Product Concentration Risk \| Revenue \| Provider Services \| Private and Other
Disaggregation of Revenue [Line Items]
% of Revenue	1.60%	2.10%	2.50%

Fair Value (Tables)

12 Months Ended

Dec. 31, 2025

Fair Value Disclosures [Abstract]

Summary of Financial Assets or Liabilities Recorded at Fair value on Recurring Basis

The financial assets or liabilities recorded at fair value on a recurring basis are set forth in the table below (in thousands):


	December 31, 2025		December 31, 2024		Valuation Technique
Assets:
Interest rate swaps (Level 2)	$	1,181	$	10,633	A
Total assets	$	1,181	$	10,633

Liabilities:
Interest rate swaps (Level 2)	$	1,561	$	—	A
Contingent consideration (Level 3)		750		8,386	C
Total liabilities	$	2,311	$	8,386

Summary of Changes in Fair Value of the Company's Contingent Consideration

The following table summarizes the changes in fair value of the Company’s contingent consideration (in thousands):


Balance at January 1, 2024	$	5,331
Additions of acquisition earn-out		200
Addition of post-closing equity adjustment feature		4,750
Contingent consideration payments		(4,156	)
Change in fair value		2,261
Balance at December 31, 2024	$	8,386
Adjustment to post-closing equity adjustment feature		(4,000	)
Contingent consideration payments		(6,370	)
Change in fair value		2,734
Balance at December 31, 2025	$	750

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2025

Income Tax Disclosure [Abstract]

Schedule of Income (loss) from Continuing Operations Before Income Taxes

Income (loss) from continuing operations before income taxes consists of the following (in thousands):


	For the Years Ended December 31,
	2025		2024			2023
U.S. operations	$	137,723	$	(95,555	)	$	(213,971	)
Foreign operations		218		237			197
Income (loss) before income taxes	$	137,941	$	(95,318	)	$	(213,774	)

Schedule of Components of Income Tax Expense (Benefit) Attributable to Income (Loss) from Continuing Operations Before Income Taxes

Income tax expense (benefit) attributable to income (loss) from continuing operations before income taxes is summarized as follows (in thousands):


	For the Years Ended December 31,
	2025		2024			2023
Current provision:
Federal	$	19,538	$	1,296		$	12,549
State		8,024		1,998			4,175
Foreign		35		50			39
Total current provision		27,597		3,344			16,763
Deferred provision:
Federal		1,524		(25,004	)		(40,106	)
State		4,024		(4,727	)		(8,165	)
Total deferred provision		5,548		(29,731	)		(48,271	)
Total income tax provision:
Federal		21,062		(23,708	)		(27,557	)
State		12,048		(2,729	)		(3,990	)
Foreign		35		50			39
Income tax expense (benefit)	$	33,145	$	(26,387	)	$	(31,508	)

Reconciliation of the U.S. Federal Income Tax Rate to Income Tax Expense (Benefit) Expressed as a Percent of Pretax Income (loss)

A reconciliation of the U.S. federal income tax rate of 21.0% to income tax expense (benefit) expressed as a percent of pretax income (loss) is as follows (in thousands):


	For the Years Ended December 31,
	2025						2024						2023
	Amount			Rate			Amount			Rate			Amount			Rate
U.S. federal statutory tax rate	$	28,968			21.0	%	$	(20,017	)		21.0	%	$	(44,893	)		21.0	%
State and local income taxes, net of federal income tax effect (1)		9,518			6.9	%		(719	)		0.8	%		(5,029	)		2.4	%
Foreign tax effects		(11	)		0.0	%		15			0.0	%		12			0.0	%
Tax credits:
Employment tax credits		(1,752	)		(1.3	)%		(2,609	)		2.7	%		(2,963	)		1.4	%
Other tax credits		(200	)		(0.1	)%		(300	)		0.3	%		(350	)		0.2	%
Nontaxable or nondeductible items:
Legal claims		130			0.1	%		(12,915	)		13.5	%		24,150			(11.3	)%
Share based compensation		(12,663	)		(9.2	)%		4,380			(4.6	)%		(2,013	)		0.9	%
Executive compensation		8,187			5.9	%		1,017			(1.1	)%		—			—
Acquisition impacts		—			—			1,819			(1.9	)%		—			—
Other		2,290			1.7	%		2,950			(3.1	)%		(1,436	)		0.6	%
Changes in unrecognized tax benefits		(1,322	)		(1.0	)%		(8	)		0.1	%		1,014			(0.5	)%
Total	$	33,145			24.0	%	$	(26,387	)		27.7	%	$	(31,508	)		14.7	%

Summary of Net Cash Paid for Income Taxes

Net cash paid for income taxes consisted of the following (in thousands):


	For the Years Ended December 31,
	2025		2024		2023
Federal	$	18,431	$	19,347	$	27,297
Aggregated state and local jurisdictions		8,449		4,156		10,202
Disaggregated state and local jurisdictions:
Virginia	*			1,410		—
Foreign	90			40		—
Net cash paid for income taxes	$	26,970	$	24,953	$	37,499

Schedule of Deferred Tax Assets and Liabilities

The tax effects of temporary differences that give rise to significant portions of the deferred tax assets and liabilities are presented below (in thousands):


	December 31, 2025			December 31, 2024
Deferred tax assets:
Accrued expenses	$	53,538		$	44,957
Allowance for credit losses and contractual allowances		36,980			22,546
Net operating losses		13,389			18,796
Share-based compensation		22,361			15,799
IRC §163(j) interest		67,438			96,961
Operating lease liability		65,906			62,587
Interest rate swaps		93			—
Other		29,870			21,325
Deferred tax assets		289,575			282,971
Valuation allowances		(7,128	)		(8,968	)
Deferred tax assets, net		282,447			274,003

Deferred tax liabilities:
Operating lease right-of-use asset		(74,027	)		(60,587	)
Property and equipment		(11,789	)		(6,575	)
Goodwill and other intangible assets		(198,377	)		(190,272	)
Insurance recovery		(4,432	)		(8,677	)
Interest rate swaps		—			(2,604	)
Deferred tax liabilities		(288,625	)		(268,715	)
Deferred income taxes, net	$	(6,178	)	$	5,288

Schedule of Unrecognized Tax Benefits

A reconciliation of the beginning and ending amount of total unrecognized tax benefits is as follows (in thousands):


	December 31, 2025			December 31, 2024
Balance at beginning of year	$	1,493		$	1,502
Decrease related to prior year tax positions		—			(9	)
Payments		(146	)		—
Lapse of statute of limitations		(1,322	)		—
Balance at end of year	$	25		$	1,493

Fair Value - Summary of Changes in Fair Value of the Company's Contingent Consideration (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Begining balance	$ 8,386	$ 5,331
Additions of acquisition earn-out		200
Addition of post-closing equity adjustment feature	(4,000)	4,750
Contingent consideration payments	(6,370)	(4,156)
Change in fair value	2,734	2,261
Ending balance	$ 750	$ 8,386

Revenues - Additional Information (Details)	12 Months Ended
Revenues - Additional Information (Details)	Dec. 31, 2025 Customer
Customer Concentration Risk \| Revenue
Product Information [Line Items]
Number of customer whose revenue was 10% or more of consolidated revenue	0

Fair Value

12 Months Ended

Dec. 31, 2025

Fair Value Disclosures [Abstract]

Fair Value

14. Fair Value

Assets and liabilities measured at fair value are based on one or more of the following three valuation techniques:

Market approach: Prices and other relevant information generated by market transactions involving identical or comparable assets or liabilities.

Cost approach: Amount that would be required to replace the service capacity of an asset (replacement cost).

Income approach: Techniques to convert future amounts to a single present amount based upon market expectations (including present value techniques, option-pricing, and excess earnings models).

Assets and Liabilities Measured at Fair Value on a Recurring Basis

The financial assets or liabilities recorded at fair value on a recurring basis are set forth in the table below (in thousands):


	December 31, 2025		December 31, 2024		Valuation Technique
Assets:
Interest rate swaps (Level 2)	$	1,181	$	10,633	A
Total assets	$	1,181	$	10,633

Liabilities:
Interest rate swaps (Level 2)	$	1,561	$	—	A
Contingent consideration (Level 3)		750		8,386	C
Total liabilities	$	2,311	$	8,386

The fair values of our interest rate swaps are based upon Level 2 inputs, which include valuation models. The key inputs for the valuation models are quoted market prices, interest rates, forward yield curves, and credit risk adjustments that are necessary to reflect the probability of default by the counterparty or us. For disclosures about the fair value measurements of our derivative instruments, refer to Note 6.

The contingent consideration represents future earn-outs and a post-closing equity adjustment feature, both associated with acquisitions, which are recognized as part of the purchase price at the estimated fair value on the acquisition date. These liabilities are classified as accrued expenses and long-term liabilities in our accompanying consolidated balance sheets.

The fair values of the liabilities associated with future earn outs were derived using the income approach with unobservable inputs, which included future earnings forecasts and present value assumptions, and there was little or no market data (Level 3). The Company will re-assess the fair values at each reporting period thereafter until settlement.

The preliminary fair value of the liability associated with the post-closing equity adjustment feature related to the Haven Hospice acquisition was derived with unobservable inputs using a Monte Carlo simulation, where the common stock price of the Company was evolved using a Geometric Brownian Motion over a period from the valuation date to the end of the fourth anniversary of closing. Estimated equity volatility was based on historical volatility, implied volatility, and peer group volatility over various periods. The Company will re-assess the fair value at each reporting period with changes in value being recorded through the consolidated statements of operations. The ultimate settlement of the liability will be through either issuance of additional equity shares and/or additional cash paid in the case of net realized losses on sales; or reduction of the outstanding balance of the seller note, in the case of net aggregate realized gain on sales up to the amounts previously paid.

The following table summarizes the changes in fair value of the Company’s contingent consideration (in thousands):


Balance at January 1, 2024	$	5,331
Additions of acquisition earn-out		200
Addition of post-closing equity adjustment feature		4,750
Contingent consideration payments		(4,156	)
Change in fair value		2,261
Balance at December 31, 2024	$	8,386
Adjustment to post-closing equity adjustment feature		(4,000	)
Contingent consideration payments		(6,370	)
Change in fair value		2,734
Balance at December 31, 2025	$	750

Assets Measured at Fair Value on a Non-Recurring Basis

The Company’s non-financial assets, such as goodwill and long-lived assets are adjusted to fair value when an impairment charge is recognized.

During the years ended December 31, 2025 and 2024, we recorded no goodwill impairment.

Long-lived assets include operating lease assets and definite-lived intangible assets. During the years ended December 31, 2025 and 2024, we concluded that sufficient indicators existed to require us to perform recoverability tests by comparing the sum of the estimated undiscounted future cash flows attributable to the assets to their carrying values. Approximately $12.6 million and $4.0 million of impairment charges related to definite-lived intangible assets and operating lease right-of-use assets were recorded in

continuing operations for the years ended December 31, 2025 and 2024, respectively. The fair value of these assets at the time of impairment was determined to be zero. To determine fair value, we used the income approach, which assumes that the future cash flows reflect current market expectations. These fair value measurements require significant judgment using Level 3 inputs, such as discounted cash flows from operations, which are not observable from the market, directly or indirectly. There is uncertainty in the projected future cash flows used in the Company’s impairment analysis, which requires the use of estimates and assumptions.

If actual performance does not achieve the projections, or if the assumptions used change in the future, we may be required to recognize impairment charges in future periods.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (bbb)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 107
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482078/820-10-55-107

Reference 3: http://www.xbrl.org/2003/role/exampleRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 100
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482078/820-10-55-100

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(3)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6A
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2E
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2E

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6A
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6A
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6A
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6A
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 940
-SubTopic 820
-Name Accounting Standards Codification
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-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478119/940-820-50-1

+ Details

Earnings Per Share ("EPS") - Additional Information (Details)	1 Months Ended	12 Months Ended
	Jan. 31, 2024	Dec. 31, 2025 $ / shares	Dec. 31, 2024 $ / shares
Earnings per Share [Line Items]
Stock split ratio	15.7027
Stock split description		15.7027-for-one stock
Maximum
Earnings per Share [Line Items]
Weighted average price per purchase contract		$ 3.8461	$ 3.8461

Discontinued Operations - Summary of the Aggregate Carrying Amounts of Assets and Liabilities Held for Sale (Parenthetical) (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Community Living Business \| Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Accumulated depreciation	$ 104,314	$ 110,417

Detail of Certain Balance Sheet Accounts - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Disclosure Text Block Supplement [Abstract]
Wages and payroll taxes	$ 131,162	$ 98,245
Checks in excess of cash balance	34,824	27,643
Compensated absences	31,543	24,360
Workers compensation insurance reserves	24,897	19,966
Health insurance reserves	15,389	14,934
Property insurance reserves	11,170	9,879
Legal settlements and professional fees	10,525	13,982
Deferred revenue	9,039	10,196
General and professional liability insurance reserves	7,696	8,328
Automobile insurance reserves	5,585	21,353
Taxes other than income taxes	3,506	1,985
Interest	1,507	8,779
Interest rate swaps	1,405
Contingent consideration		3,136
Other	44,776	32,960
Total accrued expenses	$ 333,024	$ 295,746

Segment Information - Additional Information (Details)	12 Months Ended
Segment Information - Additional Information (Details)	Dec. 31, 2025
Segment Reporting [Abstract]
Segment Reporting, CODM, Individual Title and Position or Group Name [Extensible Enumeration]	srt:ChiefExecutiveOfficerMember
Segment Reporting, CODM, Profit (Loss) Measure, How Used, Description	Segment EBITDA is used as the key profitability measure when we set our annual operating plan for each segment, is the metric with which our CODM assesses segment results, and is a key component of our annual variable compensation plans. Segment EBITDA is commonly used as an analytical indicator within the health care industry and is utilized in the evaluation of segment operating performance as it is a profit measure that is generally within the control of the operating segments.

Segment Information

12 Months Ended

Dec. 31, 2025

Segment Reporting [Abstract]

Segment Information

17. Segment Information

The Company's CODM is its Chief Executive Officer, who evaluates the performance of our segments and allocates resources based on segment EBITDA. Segment EBITDA is used as the key profitability measure when we set our annual operating plan for each segment, is the metric with which our CODM assesses segment results, and is a key component of our annual variable compensation plans. Segment EBITDA is commonly used as an analytical indicator within the health care industry and is utilized in the evaluation of segment operating performance as it is a profit measure that is generally within the control of the operating segments.

For all segments, the CODM uses segment EBITDA in the annual budgeting and monthly forecasting process. The CODM considers actual-to budget and actual-to current forecast variances for segment EBITDA on a monthly basis for evaluating performance of each segment and making decisions about allocating capital and other resources to each segment.

Segment amounts exclude certain expenses not specifically identifiable to the segments for functions performed in a centralized manner, which include accounting, finance, human resources, legal, information technology, corporate office support, and overall corporate management. Segment assets and capital expenditures are not provided to the Company’s CODM and, therefore, are not disclosed.

The following tables set forth information about the Company’s reportable segments, along with the items necessary to reconcile the segment information to the totals reported in the Company’s consolidated statements of operations as follows (in thousands):


	For the Year Ended December 31, 2025
	Pharmacy Solutions		Provider Services		Total Segments
Product revenue	$	11,445,777	$	—	$	11,445,777
Service revenue		—		1,464,787		1,464,787
Cost of drugs		9,782,109		—		9,782,109
Cost of services		—		885,356		885,356
Other direct costs (1)		725,322		—		725,322
Segment selling, general, and administrative expenses (2)		502,042		374,256		876,298
Segment depreciation and amortization expense (3)		107,198		27,479		134,677
Segment EBITDA	$	543,502	$	232,654	$	776,156


	For the Year Ended December 31, 2024
	Pharmacy Solutions		Provider Services		Total Segments
Product revenue	$	8,754,282	$	—	$	8,754,282
Service revenue		—		1,317,932		1,317,932
Cost of drugs		7,368,426		—		7,368,426
Cost of services		—		797,286		797,286
Other direct costs (1)		640,075		—		640,075
Segment selling, general, and administrative expenses (2)		462,219		340,034		802,253
Segment depreciation and amortization expense (3)		111,103		24,675		135,778
Segment EBITDA	$	394,665	$	205,287	$	599,952


	For the Year Ended December 31, 2023
	Pharmacy Solutions		Provider Services		Total Segments
Product revenue	$	6,522,450	$	—	$	6,522,450
Service revenue		—		1,168,566		1,168,566
Cost of drugs		5,291,630		—		5,291,630
Cost of services		—		711,304		711,304
Other direct costs (1)		549,086		—		549,086
Segment selling, general, and administrative expenses (2)		426,521		310,747		737,268
Segment depreciation and amortization expense (3)		115,749		22,897		138,646
Segment EBITDA	$	370,962	$	169,412	$	540,374

(1)

Other direct costs primarily includes direct labor costs, delivery costs, insurance, and depreciation and amortization expense that relates to revenue-generating assets.

(2)

Segment selling, general, and administrative expenses includes indirect labor costs, depreciation and amortization, insurance, rent, lease, supplies, professional services, maintenance, repairs, utilities, and communications expense.

(3)

Total segment depreciation and amortization expense is presented in other direct costs, costs of services, and segment general and administrative expenses, based on the associated asset.


	For the Years Ended December 31,
	2025		2024			2023
Reconciliation of income or loss:
Total Segment EBITDA	$	776,156	$	599,952		$	540,374
Segment depreciation and amortization		134,677		135,778			138,646
Expenses not allocated at segment level:
Selling, general, and administrative expenses		317,956		329,854			321,692
Depreciation and amortization		28,271		26,366			21,911
Loss on extinguishment of debt		—		12,726			—
Interest expense, net		157,311		190,546			271,899
Income tax expense (benefit)		33,145		(26,387	)		(31,508	)
Net income (loss) from continuing operations	$	104,796	$	(68,931	)	$	(182,266	)

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-21

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-URI https://asc.fasb.org/1943274/2147482810/280-10-50-31

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Debt and Derivatives - Sumarry of Estimated Fair Values of Debt Obligations (Details) $ in Millions	Dec. 31, 2025 USD ($)
Debt Instrument [Line Items]
Total debt instruments, fair value	$ 2,552,615
Significant Other Observable Inputs (Level 2)
Debt Instrument [Line Items]
Total debt instruments, fair value	2,572,112
First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments, fair value	2,521,255
First Lien Term Loan \| Significant Other Observable Inputs (Level 2)
Debt Instrument [Line Items]
Total debt instruments, fair value	2,540,164
Amortizing Notes
Debt Instrument [Line Items]
Total debt instruments, fair value	31,360
Amortizing Notes \| Significant Other Observable Inputs (Level 2)
Debt Instrument [Line Items]
Total debt instruments, fair value	$ 31,948

- Definition

Fair value portion of debt instrument payable, including, but not limited to, notes payable and loans payable.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
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- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Share-Based Compensation - Summary of RSU activity (Details) - RSUs - 2024 Incentive Plan - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Share-Based Compensation Arrangement by Share-Based Payment Award, Equity Instruments Other than Options, Nonvested, Number of Shares [Roll Forward]
Outstanding RSUs at January 1, 2025, Units	10,587,226
Granted, Units	1,931,654
Forfeited, Units	(1,364,458)
Vested, Units	(1,948,306)
Outstanding RSUs at December 31, 2025, Units	9,206,116	10,587,226
Weighted Average Grant Date Fair Value
Outstanding RSUs at January 1, 2025	$ 11.85
Granted	17.93
Forfeited	11.64
Vested	14.03
Outstanding RSUs at December 31, 2025	$ 12.68	$ 11.85
Weighted Average Remaining Contractual Term (years) at December 31, 2025	1 year 8 months 23 days	2 years 6 months 3 days
Aggregate Intrinsic Value at December 31, 2025	$ 344.8	$ 180.3

Share-Based Compensation - Additional Information (Details) $ / shares in Units, $ in Thousands	1 Months Ended		12 Months Ended
	Jan. 31, 2024	Jan. 31, 2018 shares	Dec. 31, 2025 USD ($) $ / shares shares	Dec. 31, 2024 USD ($) $ / shares shares	Dec. 31, 2023 USD ($)
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Stock split ratio	15.7027
Stock split description			15.7027-for-one stock
Common Stock, par value \| $ / shares			$ 0.01	$ 0.01
Preferred Stock , par value \| $ / shares			$ 0.01	$ 0.01
Common Stock, shares authorized \| shares			1,500,000,000	1,500,000,000
Preferred Stock, shares authorized \| shares			250,000,000	250,000,000
Preferred Stock, shares issued \| shares			0	0
Preferred Stock, shares outstanding \| shares			0	0
Total share-based compensation recognized			$ 10,900	$ 7,800
Share-based compensation			$ 70,099	69,174	$ 3,917
Weighted-average period			2 years 1 month 6 days
Cash received from stock option exercises			$ 25,300	1,500	600
Excess tax benefit with stock options			13,200
Unrecognized compensation cost, options			13,100
Total fair value at grant date of awards vested			8,500	14,600	3,600
Total Intrinsic value of stock options exercised			64,500	1,500	1,100
RSUs
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Unrecognized compensation cost, discontinued operations			13,300
Unrecognized compensation cost			$ 53,900
Weighted-average period			2 years 10 months 24 days
Total intrinsic value vested			$ 42,000	3,100
RSUs \| Minimum
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Vestig period			3 months
RSUs \| Maximum
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Vestig period			5 years
Selling, General, and Administrative Expenses
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Total share-based compensation recognized			$ 52,577	$ 55,925	$ 3,780
2017 Stock Plan
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Stock options granted \| shares		4,874,558
Option life			10 years
2017 Stock Plan \| Minimum
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Option vest upon attainment month over month			2
2017 Stock Plan \| Maximum
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Option vest upon attainment month over month			2.5
2017 Stock Plan \| Time-Based Options
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Vesting percentage		50.00%
Vestig period		5 years
2017 Stock Plan \| Tier I Performance Options
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Vesting percentage		25.00%
Vestig period		5 years
2017 Stock Plan \| Tier II Performance Options
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Vesting percentage		25.00%
2024 Incentive Plan
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Reserved for future issuance \| shares			17,119,039

Property and Equipment, Net - Summary of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Property, Plant and Equipment [Line Items]
Property and equipment	$ 609,567	$ 520,462
Less: accumulated depreciation	404,878	339,892
Property and equipment, net	204,689	180,570
Land and Land Improvements
Property, Plant and Equipment [Line Items]
Property and equipment	2,120	2,106
Furniture and Equipment
Property, Plant and Equipment [Line Items]
Property and equipment	244,505	201,364
Software
Property, Plant and Equipment [Line Items]
Property and equipment	234,445	213,358
Buildings
Property, Plant and Equipment [Line Items]
Property and equipment	9,495	8,806
Leasehold Improvements
Property, Plant and Equipment [Line Items]
Property and equipment	76,683	65,432
Property and Equipment under Finance Lease
Property, Plant and Equipment [Line Items]
Property and equipment	39,640	28,357
Construction in Progress
Property, Plant and Equipment [Line Items]
Property and equipment	$ 2,679	$ 1,039

Acquisitions (Tables)

12 Months Ended

Dec. 31, 2025

Amedisys and LHC Branches Acquisition

Business Combination [Line Items]

Schedule of Consideration Paid for Acquisitions and Estimated Fair Value of Assets Acquired and Liabilities Assumed


Accounts receivable	$	22,880
Prepaid expenses and other current assets		32
Property and equipment		5,580
Goodwill		175,042
Intangible assets		62,897
Operating lease right-of-use assets		12,604
Other assets		96
Trade accounts payable		730
Accrued expenses		10,631
Current portion of obligations under operating leases		4,177
Current portion of obligations under financing leases		1,746
Obligations under operating leases, net of current portion		8,427
Obligations under financing leases, net of current portion		3,570
Long-term liabilities		2,773
Redeemable noncontrolling interests		8,639
Noncontrolling interests		(21	)
Aggregate purchase price, net of cash acquired	$	238,459

Schedule of Unaudited Pro Forma Consolidated Financial Information


	For The Years Ended
	December 31,
	2025		2024
Revenue	$	13,255,587	$	10,413,024
Operating income	$	318,968	$	135,722
Net income (loss) attributable to BrightSpring Health Services, Inc.	$	123,662	$	(46,201	)

Haven Hospice, Inc.

Business Combination [Line Items]

Schedule of Consideration Paid for Acquisitions and Estimated Fair Value of Assets Acquired and Liabilities Assumed


Inventories	$	45
Property and equipment		495
Goodwill		45,614
Intangible assets		19,860
Operating lease right-of-use assets		7,157
Trade accounts payable		1,264
Current portion of obligations under operating leases		2,235
Obligations under operating leases, net of current portion		4,922
Aggregate purchase price	$	64,750

2024 Acquisitions

Business Combination [Line Items]

Schedule of Consideration Paid for Acquisitions and Estimated Fair Value of Assets Acquired and Liabilities Assumed


Accounts receivable	$	3,749
Inventories		1,234
Prepaid expenses and other current assets		174
Property and equipment		398
Goodwill		17,721
Intangible assets		31,233
Operating lease right-of-use assets		364
Other assets		1,438
Trade accounts payable		650
Accrued expenses		7,657
Current portion of obligations under operating leases		56
Current portion of obligations under financing leases		53
Obligations under operating leases, net of current portion		308
Obligations under financing leases, net of current portion		8
Deferred income taxes, net		1,686
Aggregate purchase price, net of cash acquired	$	45,893

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 350
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-Subparagraph (a)
-Publisher FASB
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Reference 2: http://www.xbrl.org/2003/role/exampleRef
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Reference 3: http://www.xbrl.org/2003/role/exampleRef
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+ Details

Commitments and Contingencies

12 Months Ended

Dec. 31, 2025

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

15. Commitments and Contingencies

Legal Proceedings

On March 4, 2011, Relator Marc Silver, on behalf of the U.S. Government and various state governments, filed a complaint in the United States District Court for the District of New Jersey (“the District Court”) against PharMerica, seeking relief, with respect to alleged violations of the federal False Claims Act and state false claims acts, including three times the amount of damages to the federal government plus civil penalties and no less than a certain amount for each alleged false claim, as well as any other recoveries or relief provided for by the federal False Claims Act; damages, fines, penalties, and other recoveries or relief permitted under state false claims acts; and other forms of relief, including attorneys’ fees. The complaint alleged that, in violation of the Anti-Kickback Statute and the False Claims Act, PharMerica offered below-cost or below-fair-market-value prices on drugs in exchange for so-called preferred or exclusive provider status that would allow PharMerica to dispense drugs to patients for which PharMerica could bill federal health care program payers. The U.S. Government and state governments declined to intervene in the case.

The District Court issued an order dismissing the case in full in 2016. In 2018, however, the Third Circuit Court of Appeals issued an order reinstating the case. In April 2023, the District Court issued an order denying Relator’s motion seeking to strike portions of the opinions of PharMerica’s experts and granted in part PharMerica’s motions to exclude Relator’s experts. On June 28, 2023, the District Court issued an order setting a trial date of December 4, 2023. On November 6, 2023, the District Court denied our motion for summary judgment. On November 18, 2023, the Company agreed to settle the matter without admitting liability. On May 29, 2024, the parties entered into a final settlement agreement, which was approved by both the United States Department of Justice and the District Court. The total financial impact of the settlement was $120.0 million; $110.0 million was paid during the year ended December 31, 2024, and the remaining $10.0 million was paid during the year ended December 31, 2025. The District Court entered an order dismissing the Silver action in its entirety, with prejudice, on July 3, 2024.

The Company is also party to various legal and/or administrative proceedings arising out of the operation of our programs and arising in the ordinary course of business. We record accruals for such contingencies to the extent that we conclude it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. We do not believe the ultimate liability, if any, for outstanding proceedings or claims, individually or in the aggregate, in excess of amounts already provided, will have a material adverse effect on our consolidated financial condition, results of operations, or cash flows. It is reasonably possible that an adverse determination might have an impact on a particular period. While we believe our provision for legal contingencies is adequate, the outcome of legal proceedings is difficult to predict, and we may settle legal claims or be subject to judgments for amounts that exceed our estimates.

Earnings Per Share ("EPS")

12 Months Ended

Dec. 31, 2025

Earnings Per Share [Abstract]

Earnings Per Share ("EPS")

10. Earnings Per Share (“EPS”)

Basic net income (loss) per share of common stock is calculated by dividing net income (loss) attributable to common shareholders by the weighted average number of shares outstanding for the reporting period. Diluted net income (loss) per share of common stock is computed by giving effect to all potential weighted average dilutive common stock. In periods of net loss, no potentially dilutive common shares are included in the diluted shares outstanding as the effect is anti-dilutive.

The number of additional shares of common stock related to stock option awards subject to only a time-based condition is calculated using the treasury stock method, if dilutive. Stock option awards subject to a performance condition are not included in the denominator of the diluted EPS calculation using the treasury stock method for the year ended December 31, 2023, as the performance condition had not been satisfied. Upon completion of the IPO in January 2024, the performance condition was met and a portion of the Tier I options vested (Note 11). Thus, the number of additional shares of common stock related to stock option awards subject to a performance condition are included in the denominator of the diluted EPS calculation using the treasury stock method for the years ended December 31, 2025 and 2024, if dilutive.

The number of additional shares of common stock related to restricted stock units (“RSUs”) is reflected in the denominator of the diluted EPS calculation using the treasury stock method, if dilutive.

For the years ended December 31, 2025 and 2024, the TEUs were assumed to be outstanding at the minimum settlement amount for weighted-average shares for basic EPS. For diluted EPS, the shares were assumed to be settled at a conversion factor based on the 20-day VWAP per share of the Company's common stock not to exceed 3.8461 shares per Purchase Contract, if dilutive. See Note 7 for further discussion of TEUs.

The following table sets forth the computation of basic and diluted net income (loss) per share attributable to common shareholders (in thousands, except per share amounts):


	For The Years Ended December 31,
	2025			2024			2023
Numerator:
Net income (loss) from continuing operations	$	104,796		$	(68,931	)	$	(182,266	)
Less: Net loss attributable to noncontrolling interests		(1,553	)		(2,459	)		(2,232	)
Net income (loss) from continuing operations attributable to common shareholders		106,349			(66,472	)		(180,034	)
Net income from discontinued operations		84,317			48,410			25,431
Net income (loss) attributable to common shareholders	$	190,666		$	(18,062	)	$	(154,603	)

Denominator:
Weighted-average shares outstanding - basic		202,564			192,997			117,868

Effect of dilutive securities:
Stock options		8,865			—			—
RSUs		8,345			—			—
TEUs		—			—			—
Weighted-average shares outstanding - diluted		219,774			192,997			117,868

Basic income (loss) per share attributable to common shareholders:
Continuing operations	$	0.53		$	(0.34	)	$	(1.53	)
Discontinued operations	$	0.41		$	0.25		$	0.22
Net income (loss) per share	$	0.94		$	(0.09	)	$	(1.31	)

Diluted income (loss) per share attributable to common shareholders:
Continuing operations	$	0.48		$	(0.34	)	$	(1.53	)
Discontinued operations	$	0.39		$	0.25		$	0.22
Net income (loss) per share	$	0.87		$	(0.09	)	$	(1.31	)


	For The Years Ended December 31,
	2025		2024 (1)		2023 (1)
Stock options		259		14,936		14,140
RSUs		—		10,587		—
TEUs		—		—		—
Total		259		25,523		14,140

All share and per share amounts have been retroactively adjusted to reflect the effects of a 15.7027-for-one stock split that occurred in January 2024 in conjunction with the IPO Offerings.

Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Loss Contingencies [Line Items]
Estimated settlement amount		$ 120.0
Long-term Liabilities Current
Loss Contingencies [Line Items]
Paid settlement amount	$ 10.0	$ 110.0

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 275
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-Name Accounting Standards Codification
-Section 50
-Paragraph 9
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-URI https://asc.fasb.org/1943274/2147482861/275-10-50-9

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483076/450-20-50-1

+ Details

Earnings Per Share ("EPS") - Summary of Basic and Diluted Net Income (Loss) Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Numerator:
Net income (loss) from continuing operations	$ 104,796	$ (68,931)	$ (182,266)
Less: Net loss attributable to noncontrolling interests	(1,553)	(2,459)	(2,232)
Net income (loss) from continuing operations attributable to common shareholders	106,349	(66,472)	(180,034)
Net income from discontinued operation	84,317	48,410	25,431
Net income (loss) attributable to common shareholders	$ 190,666	$ (18,062)	$ (154,603)
Denominator:
Weighted-average shares outstanding - basic	202,564,000	192,997,000	117,868,000
Weighted-average shares outstanding - diluted	219,774,000	192,997,000	117,868,000
Basic income (loss) per share attributable to common shareholders:
Continuing operations	$ 0.53	$ (0.34)	$ (1.53)
Discontinued operations	0.41	0.25	0.22
Net income (loss) per share	0.94	(0.09)	(1.31)
Diluted income (loss) per share attributable to common shareholders:
Continuing operations	0.48	(0.34)	(1.53)
Discontinued operations	0.39	0.25	0.22
Net income (loss) per share	$ 0.87	$ (0.09)	$ (1.31)
Stock Options
Denominator:
Weighted-average shares outstanding - diluted	8,865,000	0	0
RSUs
Denominator:
Weighted-average shares outstanding - diluted	8,345,000	0	0
TEUs
Denominator:
Weighted-average shares outstanding - diluted	0	0	0

Lease Arrangements - Schedule of Future Minimum Lease Payments of Leases (Details) $ in Thousands	Dec. 31, 2025 USD ($)
Finance Lease Costs
2026	$ 7,833
2027	6,788
2028	5,193
2029	2,825
2030	461
Thereafter	50
Total future minimum lease payments	23,150
Less: imputed interest	1,812
Total present value of lease liabilities	21,338
Operating Lease Costs
2026	53,793
2027	49,308
2028	38,989
2029	26,438
2030	18,491
Thereafter	22,491
Total future minimum lease payments	209,510
Less: imputed interest	31,154
Total present value of lease liabilities	$ 178,356

Earnings Per Share ("EPS") - Summary of Shares Excluded from Computation of Diluted Net Income (Loss) Per Share (Details) - shares shares in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares excluded from computation of diluted net loss per share	259	25,523	14,140
Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares excluded from computation of diluted net loss per share	259	14,936	14,140
RSUs
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares excluded from computation of diluted net loss per share	0	10,587	0
TEUs
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares excluded from computation of diluted net loss per share	0	0	0

Property and Equipment, Net

12 Months Ended

Dec. 31, 2025

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

12. Property and Equipment, Net

Property and equipment, net is summarized as follows (in thousands):


	December 31, 2025		December 31, 2024
Land and land improvements	$	2,120	$	2,106
Furniture and equipment		244,505		201,364
Software		234,445		213,358
Buildings		9,495		8,806
Leasehold improvements		76,683		65,432
Property and equipment under finance lease (Note 13)		39,640		28,357
Construction in progress		2,679		1,039
Property and equipment		609,567		520,462
Less: accumulated depreciation		404,878		339,892
Property and equipment, net	$	204,689	$	180,570

Depreciation expense is recorded within cost of goods, cost of services, and selling, general, and administrative expenses within our consolidated statements of operations, depending on the nature of the underlying fixed assets. Depreciation expense was $71.8 million, $66.8 million and $57.3 million for the years ended December 31, 2025, 2024, and 2023, respectively.

Consolidated Statements of Comprehensive Loss (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Statement of Comprehensive Income [Abstract]
Income tax effects of net change in fair value	$ (1,038)	$ (5,149)	$ (4,591)
Income tax effects of amounts reclassified to earnings	$ 3,736	$ 8,646	$ 7,683

Tangible Equity Units - Schedule of Number of Common Stock Issued Based on 20 Day Volume Weighted-Average Price of Common Stock (Details)	12 Months Ended
	Dec. 31, 2025 USD ($) $ / shares shares
Maximum
Class of Stock [Line Items]
VWAP of BTSG Common Stock	$ 15.28
Common Stock Issued \| shares	30,800,000
Minimum
Class of Stock [Line Items]
VWAP of BTSG Common Stock	$ 13.00
Common Stock Issued \| shares	26,200,000
Greater than $15.28
Class of Stock [Line Items]
Common Stock Issued \| shares	3.2733
Greater than $15.28 \| Minimum
Class of Stock [Line Items]
VWAP of BTSG Common Stock	$ 15.28
Equal to or less than $15.28 but greater than or equal to $13.00
Class of Stock [Line Items]
Amount to determine Common Stock Issuance \| $	$ 50
Equal to or less than $15.28 but greater than or equal to $13.00 \| Maximum
Class of Stock [Line Items]
VWAP of BTSG Common Stock	$ 15.28
Equal to or less than $15.28 but greater than or equal to $13.00 \| Minimum
Class of Stock [Line Items]
VWAP of BTSG Common Stock	$ 13
Less than $13.00
Class of Stock [Line Items]
Common Stock Issued \| shares	3.8461
Less than $13.00 \| Maximum
Class of Stock [Line Items]
VWAP of BTSG Common Stock	$ 13

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Statement of Financial Position [Abstract]
Property and equipment, net of accumulated depreciation	$ 404,878	$ 339,892
Common Stock, par value	$ 0.01	$ 0.01
Common Stock, shares authorized	1,500,000,000	1,500,000,000
Common Stock, Shares, Issued	192,124,125	174,245,990
Common Stock, shares outstanding	192,124,125	174,245,990
Preferred Stock , par value	$ 0.01	$ 0.01
Preferred Stock, shares authorized	250,000,000	250,000,000
Preferred Stock, shares issued	0	0
Preferred Stock, shares outstanding	0	0

Tangible Equity Units

12 Months Ended

Dec. 31, 2025

Equity [Abstract]

Tangible Equity Units

7. Tangible Equity Units

Concurrently with the IPO, we issued 8,000,000 TEUs, which have a stated amount of $50.00 per unit. Each TEU is comprised of a prepaid stock purchase contract (“Purchase Contract”) and a senior amortizing note (“Amortizing Note”) due February 1, 2027, each issued by the Company. Each TEU may be separated by a holder into its constituent Purchase Contract and Amortizing Note, each of which is considered a freestanding financial instrument. The proceeds from the issuance were allocated to equity and debt based on the relative fair value of the respective components of each TEU as follows (in thousands, except per unit values):


	Equity Component		Debt Component		Total
Fair value per unit	$	41.3382	$	8.6618	$	50.00

Gross proceeds	$	330,706	$	69,294	$	400,000
Less: issuance costs		9,095		1,905		11,000
Net proceeds	$	321,611	$	67,389	$	389,000

The value allocated to the Purchase Contract is reflected net of issuance costs in additional paid-in capital on the consolidated balance sheet. The value allocated to the Amortizing Notes are reflected in long-term debt, with payments expected in the next twelve months reflected in current portion of long-term debt, in the consolidated balance sheet. The long-term portion of the Amortizing Notes as of December 31, 2025 and 2024 was $6.6 million and $32.9 million, respectively. The short-term portion of the Amortizing Notes as of December 31, 2025 and 2024 was $24.8 million and $20.9 million, respectively. Issuance costs related to the Amortizing Notes are reflected as a reduction of the carrying amount and will be amortized through the maturity date using the effective interest rate method.

On each February 1, May 1, August 1, and November 1, we pay equal quarterly cash installments of $0.8438 per Amortizing Note commencing on May 1, 2024, except for the May 1, 2024 installment payment, which was $0.8531 per Amortizing Note, with a final installment payment date of February 1, 2027. Each installment payment constitutes a payment of interest and a partial repayment of principal. The Company paid $27.0 and $20.3 million in TEU principal and interest payments during the years ended December 31, 2025 and 2024, respectively.

The Amortizing Notes rank equally in right of payment with all other existing and future unsecured senior indebtedness and rank senior to all of our existing and future indebtedness, if any, that is subordinated to the Amortizing Notes. At any time prior to the second scheduled trading day immediately preceding February 1, 2027, a holder may elect to settle its Purchase Contract early, in whole or in part, at an early settlement rate equal to the minimum settlement rate. The Company has the right to settle the Purchase Contracts on or after November 1, 2024, in whole but not in part, on a date fixed by it at an early mandatory settlement rate equal to the maximum settlement rate, subject to certain exceptions. During the years ended December 31, 2025 and 2024, 4,384,020 and 31,211 TEUs were converted at the holder's option.

Unless settled earlier at the holder’s option or at the Company's election, each Purchase Contract will, subject to postponement in certain limited circumstances, automatically settle on February 1, 2027 for a number of shares of our common stock, subject to certain anti-dilution adjustments, based upon the 20-day volume-weighted average price (“VWAP”) of our common stock as follows:


VWAP of BTSG Common Stock		Common Stock Issued
Greater than $15.28		3.2733 shares (minimum settlement rate)
Equal to or less than $15.28 but greater than or equal to $13.00		$50 divided by VWAP
Less than $13.00		3.8461 shares (maximum settlement rate)

The Purchase Contracts are mandatorily convertible into a minimum of 26.2 million shares or a maximum of 30.8 million shares of our common stock on the mandatory settlement date (unless redeemed by us or settled earlier at the unit holder's option). The 26.2 million minimum shares are included in the calculation of basic weighted average shares outstanding. The difference between the minimum and maximum shares represents potentially dilutive securities, which are included in the calculation of diluted weighted average shares outstanding on a pro rata basis to the extent that the average applicable market value is equal to or greater than $13.00 but is less than or equal to $15.28 during the period (see Note 10).

Lease Arrangements - Additional Information (Details)	12 Months Ended
Lease Arrangements - Additional Information (Details)	Dec. 31, 2025
Lessee, Lease, Description [Line Items]
Real estate and equipment lease expiration year	2034
Minimum
Lessee, Lease, Description [Line Items]
Real estate and office space leases renewal period	3 years
Maximum
Lessee, Lease, Description [Line Items]
Real estate and office space leases renewal period	10 years

Segment Information - Schedule of Segment Reporting Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Reconciliation of profit or loss:
Segment depreciation and amortization	$ 164,277	$ 204,482	$ 202,336
Expenses not allocated at segment level:
Net income (loss) from continuing operations	104,796	(68,931)	(182,266)
Operating Segments
Reconciliation of profit or loss:
Total Segment EBITDA	776,156	599,952	540,374
Segment depreciation and amortization	134,677	135,778	138,646
Material Reconciling Items
Expenses not allocated at segment level:
Selling, general, and administrative expenses	317,956	329,854	321,692
Depreciation and amortization	28,271	26,366	21,911
Loss on extinguishment of debt		12,726
Interest expense, net	157,311	190,546	271,899
Income tax expense (benefit)	$ 33,145	$ (26,387)	$ (31,508)

Revenues

12 Months Ended

Dec. 31, 2025

Revenue from Contract with Customer [Abstract]

Revenues

3. Revenues

The Company is substantially dependent on revenues received under contracts with federal, state, and local government agencies. Operating funding sources are generally earned from Medicaid, Medicare, commercial insurance reimbursement, and private and other payors. There is no single customer whose revenue was 10% or more of our consolidated revenue. The following tables set forth revenue by payor type (in millions):


	Pharmacy Solutions
	For the Years Ended December 31,
	2025					2024					2023
	Revenue		% of Revenue			Revenue		% of Revenue			Revenue		% of Revenue
Commercial insurance	$	3,114.6		24.1	%	$	2,360.0		23.4	%	$	1,657.7		21.6	%
Medicaid		1,093.2		8.5	%		829.1		8.2	%		656.1		8.5	%
Medicare Part A		572.8		4.4	%		546.4		5.4	%		549.3		7.1	%
Medicare Part B		76.4		0.6	%		70.3		0.7	%		61.2		0.8	%
Medicare Part C		2,277.5		17.6	%		1,547.1		15.4	%		1,384.3		18.0	%
Medicare Part D		4,097.8		31.7	%		3,202.0		31.8	%		2,031.9		26.4	%
Private & other		213.5		1.8	%		199.4		2.0	%		182.0		2.4	%
	$	11,445.8		88.7	%	$	8,754.3		86.9	%	$	6,522.5		84.8	%


	Provider Services
	For the Years Ended December 31,
	2025					2024					2023
	Revenue		% of Revenue			Revenue		% of Revenue			Revenue		% of Revenue
Commercial insurance	$	188.7		1.5	%	$	168.1		1.7	%	$	152.5		2.0	%
Medicaid		402.0		3.1	%		337.4		3.3	%		323.0		4.2	%
Medicare Part A		521.5		4.0	%		453.2		4.5	%		409.3		5.3	%
Medicare Part B		6.4		0.0	%		25.6		0.3	%		21.6		0.3	%
Medicare Part C		135.6		1.1	%		117.9		1.2	%		66.1		0.9	%
Private & other		210.6		1.6	%		215.7		2.1	%		196.0		2.5	%
	$	1,464.8		11.3	%	$	1,317.9		13.1	%	$	1,168.5		15.2	%


	Consolidated
	For the Years Ended December 31,
	2025					2024					2023
	Revenue		% of Revenue			Revenue		% of Revenue			Revenue		% of Revenue
Commercial insurance	$	3,303.3		25.6	%	$	2,528.1		25.1	%	$	1,810.2		23.6	%
Medicaid		1,495.2		11.6	%		1,166.5		11.5	%		979.1		12.7	%
Medicare Part A		1,094.3		8.4	%		999.6		9.9	%		958.6		12.4	%
Medicare Part B		82.8		0.6	%		95.9		1.0	%		82.8		1.1	%
Medicare Part C		2,413.1		18.7	%		1,665.0		16.6	%		1,450.4		18.9	%
Medicare Part D		4,097.8		31.7	%		3,202.0		31.8	%		2,031.9		26.4	%
Private & other		424.1		3.4	%		415.1		4.1	%		378.0		4.9	%
	$	12,910.6		100.0	%	$	10,072.2		100.0	%	$	7,691.0		100.0	%

Refer to Note 17 for the disaggregation of revenues by segment.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

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+ Details

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Current assets:
Cash and cash equivalents	$ 88,370	$ 60,954
Accounts receivable, net of allowance for credit losses	989,719	902,782
Inventories	815,180	636,561
Prepaid expenses and other current assets	118,592	161,310
Total current assets	2,894,050	1,893,054
Property and equipment, net of accumulated depreciation of $404,878 and $339,892 at December 31, 2025 and 2024, respectively	204,689	180,570
Goodwill	2,545,673	2,363,884
Intangible assets, net of accumulated amortization	557,555	595,224
Operating lease right-of-use assets, net	171,632	161,032
Deferred income taxes, net	0	5,288
Other assets	39,712	39,128
Total assets	6,413,311	5,926,140
Current liabilities:
Trade accounts payable	1,217,946	923,926
Accrued expenses	333,024	295,746
Current portion of obligations under operating leases	42,936	38,910
Current portion of obligations under financing leases	6,794	3,463
Current portion of long-term debt	52,340	48,725
Total current liabilities	1,849,034	1,428,333
Obligations under operating leases, net of current portion	135,420	129,467
Obligations under financing leases, net of current portion	14,544	6,530
Long-term debt, net of current portion	2,455,204	2,561,858
Deferred income taxes, net	6,178
Long-term liabilities	66,565	71,190
Total liabilities	4,526,945	4,274,555
Redeemable noncontrolling interests	11,227	3,730
Shareholders' equity:
Common stock, $0.01 par value, 1,500,000,000 shares authorized, 192,124,125 and 174,245,990 shares issued and outstanding at December 31, 2025 and 2024, respectively	1,921	1,742
Preferred stock, $0.01 par value, 250,000,000 authorized; no shares issued and outstanding at December 31, 2025 and 2024	0
Additional paid-in capital	1,954,482	1,866,850
Accumulated deficit	(74,647)	(222,155)
Accumulated other comprehensive (loss) income	(6,691)	1,418
Total shareholders' equity	1,875,065	1,647,855
Noncontrolling interest	74	0
Total equity	1,875,139	1,647,855
Total liabilities, redeemable noncontrolling interests, and equity	6,413,311	5,926,140
Discontinued operation held for sale
Current assets:
Current assets held for sale	882,189	131,447
Non-current assets held for sale	0	687,960
Current liabilities:
Current liabilities held for sale	195,994	117,563
Non-current liabilities held for sale	$ 0	$ 77,177

Income Taxes - Schedule of Components of Income Tax Expense (Benefit) Attributable to Income (Loss) From Continuing Operations Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Components of Income Tax Expense (Benefit), Continuing Operations [Abstract]
Current provision, Federal	$ 19,538	$ 1,296	$ 12,549
Current provision, State	8,024	1,998	4,175
Current provision, Foreign	35	50	39
Total current provision	27,597	3,344	16,763
Deferred provision, Federal	1,524	(25,004)	(40,106)
Deferred provision, State	4,024	(4,727)	(8,165)
Total deferred provision	5,548	(29,731)	(48,271)
Income tax provision, Federal	21,062	(23,708)	(27,557)
Income tax provision, State	12,048	(2,729)	(3,990)
Income tax provision, Foreign	35	50	39
Income tax expense (benefit)	$ 33,145	$ (26,387)	$ (31,508)	$ 33,145

Discontinued Operations - Summary of the Significant Non-cash Items and Purchases of Property and Equipment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Cash flows from operating activities of discontinued operations:
Share-based compensation	$ 70,099	$ 69,174	$ 3,917
Community Living Business \| Discontinued Operations
Cash flows from operating activities of discontinued operations:
Depreciation and amortization	1,329	42,338	41,779
Share-based compensation	10,934	7,838	137
Impairment of long-lived assets	0	6,238	8,134
Cash flows from investing activities of discontinued operations:
Purchases of property and equipment	$ 12,313	$ 10,429	$ 11,983

Goodwill and Intangible Assets - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Schedule Of Intangible Assets [Line Items]
Goodwill impairment charges	$ 0	$ 0
Amortization expense	$ 91,100,000	$ 95,300,000	$ 103,300,000
Income Approach
Schedule Of Intangible Assets [Line Items]
Goodwill, measurement input	50.00%
Market Approach
Schedule Of Intangible Assets [Line Items]
Goodwill, measurement input	50.00%

- Definition

The aggregate expense charged against earnings to allocate the cost of intangible assets (nonphysical assets not used in production) in a systematic and rational manner to the periods expected to benefit from such assets.

+ References

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+ Details

- Definition

Amount of impairment loss from asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

+ References + Details

Detail of Certain Balance Sheet Accounts - Schedule of Prepaid Expenses and Other Current Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Disclosure Text Block Supplement [Abstract]
Non-trade receivables	$ 38,196	$ 45,428
Rebate receivable	32,407	49,538
Prepaid insurance	13,255	13,892
Inventory returns receivable	11,019	11,245
Prepaid maintenance	6,025	3,644
Income tax receivable	864	13,468
Interest rate swaps	0	10,633
Other prepaid expenses and current assets	16,826	13,462
Total prepaid expenses and other current assets	$ 118,592	$ 161,310

Discontinued Operations - Additional Information (Details) $ in Millions	Jan. 17, 2025 USD ($)
Community Living Business \| Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Cash receivable for the disposal including discontinued operation	$ 835.0

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Dec. 31, 2025
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Operating activities:
Net income (loss)	$ 189,113	$ (20,521)	$ (156,835)
Adjustments to reconcile net income (loss) to cash provided by operating activities:
Depreciation and amortization	164,277	204,482	202,336
Impairment of long-lived assets	12,628	10,235	10,631
Change in fair value of contingent consideration, net	(1,266)	2,261
Payment of contingent consideration in excess of acquisition date fair value	(6,170)	(2,351)
Provision for credit losses	56,227	33,998	23,237
Amortization of deferred debt issuance costs	11,242	12,108	20,916
Share-based compensation	70,099	69,174	3,917
Deferred income taxes, net	14,842	(25,914)	(52,632)
Loss on extinguishment of debt		12,726
Loss on disposition of fixed assets	2,076	101	349
Other	(4,356)	(2,451)	(572)
Change in operating assets and liabilities, net of acquisitions:
Accounts receivable	(131,287)	(179,040)	(127,246)
Prepaid expenses and other current assets	30,669	7,595	(34,899)
Inventories	(177,906)	(236,514)	28,660
Trade accounts payable	264,171	303,209	105,649
Accrued expenses	32,003	(144,580)	193,633
Other assets and liabilities	(36,193)	(20,744)	(6,361)
Net cash provided by operating activities	490,169	23,774	210,783
Investing activities:
Purchases of property and equipment	(95,484)	(80,913)	(73,527)
Acquisitions of businesses, net of cash acquired	(204,564)	(59,797)	(63,058)
Other	(5,031)	473	2,152
Net cash used in investing activities	(305,079)	(140,237)	(134,433)
Financing activities:
Long-term debt borrowings		2,566,000
Long-term debt repayments	(50,275)	(3,396,334)	(30,441)
Proceeds from issuance of common stock on initial public offering, net		656,485
Proceeds from issuance of tangible equity units, net		389,000
(Repayments) borrowings of the Revolving Credit Facility, net	(63,300)	12,600	(24,100)
Payment of debt issuance costs		(47,045)
Repurchase of shares of common stock	(43,173)	(650)	(650)
Proceeds from shares issued under share-based compensation plan	25,281	1,535	598
Payment of taxes related to net share settlement of equity awards	(7,554)	(1,196)
Repurchase of stock options			(10,000)
Payment of contingent consideration up to acquisition date fair value	(200)	(1,805)	(1,453)
Purchase of redeemable noncontrolling interest	(5,100)	(2,316)
Investment in noncontrolling interests			735
Payment of financing lease obligations	(13,545)	(11,629)	(11,596)
Net cash (used in) provided by financing activities	(157,866)	164,645	(76,907)
Net increase (decrease) in cash and cash equivalents	27,224	48,182	(557)
Cash and cash equivalents at beginning of year	61,253	13,071	13,628
Cash and cash equivalents at end of year	88,477	61,253	13,071
Cash and cash equivalents included in assets held for sale at end of year	107	299	641
Cash and cash equivalents included in continuing operations at end of year	88,370	60,954	12,430
Supplemental disclosures of cash flow information:
Interest, net	183,512	211,387	303,530
Income taxes, net of refunds	26,970	24,953	37,499
Supplemental schedule of non-cash investing and financing activities:
Notes issued and contingent liabilities assumed in connection with acquisitions		22,302	7,519
Financing lease obligations (Note 13)	20,252	13,095	11,562
Repurchases of common stock in accounts payable			650
Purchases of property and equipment in accounts payable	6,767	12,136	12,981
Acquisition consideration in accounts payable	$ 42,203		$ 2,500
Consideration for purchase of redeemable noncontrolling interest in accounts payable		5,100
Shares issued in connection with acquisitions		$ 31,081

Income Taxes - Reconciliation of Beginning and Ending Amount of Total Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Balance at beginning of year	$ 1,493	$ 1,502
Decrease related to prior year tax positions	0	(9)
Payments	(146)	0
Lapse of statute of limitations	(1,322)	0
Balance at end of year	$ 25	$ 1,493

Detail of Certain Balance Sheet Accounts

12 Months Ended

Dec. 31, 2025

Disclosure Text Block Supplement [Abstract]

Detail of Certain Balance Sheet Accounts

. Detail of Certain Balance Sheet Accounts

Prepaid expenses and other current assets consist of the following (in thousands):


	December 31, 2025		December 31, 2024
Non-trade receivables	$	38,196	$	45,428
Rebate receivable		32,407		49,538
Prepaid insurance		13,255		13,892
Inventory returns receivable		11,019		11,245
Prepaid maintenance		6,025		3,644
Income tax receivable		864		13,468
Interest rate swaps		—		10,633
Other prepaid expenses and current assets		16,826		13,462
Total prepaid expenses and other current assets	$	118,592	$	161,310

Other assets consist of the following (in thousands):


	December 31, 2025		December 31, 2024
Other investments	$	7,481	$	1,427
Insurance recoveries		7,251		7,564
Cloud computing		6,017		7,362
Deposits		5,722		6,733
Deferred compensation		4,702		3,777
Notes receivable		4,012		8,577
Deferred debt issuance costs		1,764		2,470
Interest rate swaps		1,181		—
Equity method investments		721		420
Other assets		861		798
Total other assets	$	39,712	$	39,128

Accrued expenses consist of the following (in thousands):


	December 31, 2025		December 31, 2024
Wages and payroll taxes	$	131,162	$	98,245
Checks in excess of cash balance		34,824		27,643
Compensated absences		31,543		24,360
Workers compensation insurance reserves		24,897		19,966
Health insurance reserves		15,389		14,934
Property insurance reserves		11,170		9,879
Legal settlements and professional fees		10,525		13,982
Deferred revenue		9,039		10,196
General and professional liability insurance reserves		7,696		8,328
Automobile insurance reserves		5,585		21,353
Taxes other than income taxes		3,506		1,985
Interest		1,507		8,779
Interest rate swaps		1,405		—
Contingent consideration		—		3,136
Other		44,776		32,960
Total accrued expenses	$	333,024	$	295,746

Long-term liabilities consist of the following (in thousands):


	December 31, 2025		December 31, 2024
Workers compensation insurance reserves	$	25,369	$	25,360
General and professional liability insurance reserves		25,032		21,182
Automobile insurance reserves		9,849		9,034
Deferred compensation		4,702		3,777
Contingent consideration		750		5,250
Interest rate swaps		156		—
Other		707		6,587
Total long-term liabilities	$	66,565	$	71,190

Segment Information (Tables)

12 Months Ended

Dec. 31, 2025

Segment Reporting [Abstract]

Schedule of Segment Reporting Information


	For the Year Ended December 31, 2025
	Pharmacy Solutions		Provider Services		Total Segments
Product revenue	$	11,445,777	$	—	$	11,445,777
Service revenue		—		1,464,787		1,464,787
Cost of drugs		9,782,109		—		9,782,109
Cost of services		—		885,356		885,356
Other direct costs (1)		725,322		—		725,322
Segment selling, general, and administrative expenses (2)		502,042		374,256		876,298
Segment depreciation and amortization expense (3)		107,198		27,479		134,677
Segment EBITDA	$	543,502	$	232,654	$	776,156


	For the Year Ended December 31, 2024
	Pharmacy Solutions		Provider Services		Total Segments
Product revenue	$	8,754,282	$	—	$	8,754,282
Service revenue		—		1,317,932		1,317,932
Cost of drugs		7,368,426		—		7,368,426
Cost of services		—		797,286		797,286
Other direct costs (1)		640,075		—		640,075
Segment selling, general, and administrative expenses (2)		462,219		340,034		802,253
Segment depreciation and amortization expense (3)		111,103		24,675		135,778
Segment EBITDA	$	394,665	$	205,287	$	599,952


	For the Year Ended December 31, 2023
	Pharmacy Solutions		Provider Services		Total Segments
Product revenue	$	6,522,450	$	—	$	6,522,450
Service revenue		—		1,168,566		1,168,566
Cost of drugs		5,291,630		—		5,291,630
Cost of services		—		711,304		711,304
Other direct costs (1)		549,086		—		549,086
Segment selling, general, and administrative expenses (2)		426,521		310,747		737,268
Segment depreciation and amortization expense (3)		115,749		22,897		138,646
Segment EBITDA	$	370,962	$	169,412	$	540,374

(1)

Other direct costs primarily includes direct labor costs, delivery costs, insurance, and depreciation and amortization expense that relates to revenue-generating assets.

(2)

(3)

Total segment depreciation and amortization expense is presented in other direct costs, costs of services, and segment general and administrative expenses, based on the associated asset.


	For the Years Ended December 31,
	2025		2024			2023
Reconciliation of income or loss:
Total Segment EBITDA	$	776,156	$	599,952		$	540,374
Segment depreciation and amortization		134,677		135,778			138,646
Expenses not allocated at segment level:
Selling, general, and administrative expenses		317,956		329,854			321,692
Depreciation and amortization		28,271		26,366			21,911
Loss on extinguishment of debt		—		12,726			—
Interest expense, net		157,311		190,546			271,899
Income tax expense (benefit)		33,145		(26,387	)		(31,508	)
Net income (loss) from continuing operations	$	104,796	$	(68,931	)	$	(182,266	)

Discontinued Operations - Summary of the Financial Results of the Community Living Business (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income from discontinued operations, net of income taxes	$ 84,317	$ 48,410	$ 25,431
Community Living Business \| Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Services revenue	1,234,403	1,194,258	1,135,159
Cost of services	840,172	872,250	840,361
Gross profit	394,231	322,008	294,798
Selling, general, and administrative expenses	254,753	223,588	205,743
Operating income of discontinued operations	139,478	98,420	89,055
Interest expense, net	29,917	37,840	52,694
Income from discontinued operations before income taxes	109,561	60,580	36,361
Income tax expense from discontinued operations	25,244	12,170	10,930
Income from discontinued operations, net of income taxes	$ 84,317	$ 48,410	$ 25,431

Income Taxes - Schedule of Reconciliation of Effective Tax Rate (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
U.S. federal statutory tax rate	21.00%	21.00%	21.00%
State and local income taxes, net of federal income tax effect	6.90%	0.80%	2.40%
Foreign tax effects	0.00%	0.00%	0.00%
Employment tax credits	(1.30%)	2.70%	1.40%
Other tax credits	(0.10%)	0.30%	0.20%
Legal claims	0.10%	13.50%	(11.30%)
Share-based compensation	(9.20%)	(4.60%)	0.90%
Executive compensation	5.90%	(1.10%)	0.00%
Acquisition impacts	0.00%	(1.90%)	0.00%
Other	1.70%	(3.10%)	0.60%
Changes in unrecognized tax benefits	(1.00%)	0.10%	(0.50%)
Total	24.00%	27.70%	14.70%
U.S. federal statutory tax rate, Amount	$ 28,968	$ (20,017)	$ (44,893)
State and local income taxes, net of federal income tax effect, Amount	9,518	(719)	(5,029)
Foreign tax effects, Amount	(11)	15	12
Employment tax credits, Amount	(1,752)	(2,609)	(2,963)
Other tax credits	(200)	(300)	(350)
Legal claims, Amount	130	(12,915)	24,150
Share based compensation, Amount	(12,663)	4,380	(2,013)
Executive compensation, Amount	8,187	1,017
Acquisition impacts, Amounts		1,819
Other, Amount	2,290	2,950	(1,436)
Changes in unrecognized tax benefits, Amount	(1,322)	(8)	1,014
Income tax expense (benefit)	$ 33,145	$ (26,387)	$ (31,508)	$ 33,145

Lease Arrangements - Summary of Supplemental Cash Flow Information Related to Leases (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Cash Paid For Amounts Included In The Measurement Of Lease Liabilities [Abstract]
Operating cash flows from finance leases	$ (893)	$ (2,443)	$ (2,254)
Financing cash flows from finance leases	(4,624)	(4,220)	(4,082)
Operating cash flows from operating leases	(58,206)	(55,269)	(51,621)
Right-of-use assets obtained in exchange for new finance lease liabilities	16,977	3,171	3,726
Right-of-use assets obtained in exchange for new operating lease liabilities	$ 57,097	$ 38,718	$ 35,555
Weighted-average remaining lease term (in years):
Finance leases	3 years 3 months 18 days	3 years 1 month 6 days	3 years 1 month 6 days
Operating leases	4 years 6 months	4 years 10 months 24 days	5 years 6 months
Weighted-average discount rate:
Finance leases	6.70%	6.70%	7.20%
Operating leases	6.70%	6.80%	7.10%

Consolidated Statements of Shareholders' Equity - USD ($)
$ in Thousands

Total

Common Stock

Additional Paid-In Capital

(Accumulated Deficit) Retained Earnings

Accumulated Other Comprehensive Income (Loss)

Noncontrolling Interest

Balance at Dec. 31, 2022

$ 754,776

$ 1,179

$ 778,121

$ (45,716)

$ 21,192

Balance, shares at Dec. 31, 2022

117,860,839

Net loss

^[1]

(154,603)

(154,538)

$ (65)

Other comprehensive income (loss), net of tax

(8,648)

Share-based compensation

3,917

Shares issued under share-based compensation plan, including tax effects

598

$ 1

597

Shares issued under share-based compensation plan, including tax effects, shares

77,870

Repurchase of stock options

(10,000)

Investment in noncontrolling interest

670

(65)

735

Repurchase of shares of common stock

(1,300)

$ (1)

(1,299)

Repurchase of shares of common stock, Shares

(81,654)

Balance at Dec. 31, 2023

585,410

$ 1,179

771,336

(200,319)

12,544

670

Balance, shares at Dec. 31, 2023

117,857,055

Net loss

^[1]

(18,732)

(18,062)

(670)

Other comprehensive income (loss), net of tax

(11,126)

Share-based compensation

69,174

Exercise of stock options

1,535

$ 2

1,533

Exercise of stock options, shares

234,608

Issuance of common stock for settlement of RSUs

$ 2

(2)

Issuance of common stock for settlement of RSUs, shares

241,971

Tax effect of net share settlement of equity awards

(1,196)

$ (1)

(1,195)

Tax effect of net share settlement of equity awards, Shares

(93,678)

Shares issued for payment of acquisition

31,081

$ 26

31,055

Shares issued for payment of acquisition, shares

2,570,503

Derecognition of redeemable noncontrolling interest, net of tax

8,665

12,439

(3,774)

Issuance of common stock on initial public offering, net

^[2]

661,777

$ 533

661,244

Issuance of common stock on initial public offering, net, shares

^[2]

53,333,334

Proceeds from stock purchase contract issued under tangible equity units, net

^[3]

321,611

Other

(344)

$ 1

(345)

Other, shares

102,197

Balance at Dec. 31, 2024

1,647,855

$ 1,742

1,866,850

(222,155)

1,418

Balance, shares at Dec. 31, 2024

174,245,990

Net loss

^[1]

190,256

190,666

(410)

Other comprehensive income (loss), net of tax

(8,109)

Share-based compensation

70,099

Exercise of stock options

25,281

$ 34

25,247

Exercise of stock options, shares

3,402,905

Issuance of common stock for settlement of RSUs

$ 19

(19)

Issuance of common stock for settlement of RSUs, shares

1,948,306

Tax effect of net share settlement of equity awards

(7,554)

$ (3)

(7,551)

Tax effect of net share settlement of equity awards, Shares

(323,293)

Conversion of tangible equity units into common stock, Shares

14,350,217

Conversion of tangible equity units into common stock

$ 144

(144)

Repurchase of shares of common stock

(43,173)

$ (15)

(43,158)

Repurchase of shares of common stock, Shares

(1,500,000)

Other

484

Balance at Dec. 31, 2025

$ 1,875,139

$ 1,921

$ 1,954,482

$ (74,647)

$ (6,691)

$ 74

Balance, shares at Dec. 31, 2025

192,124,125

[1]	Net income (loss) to the Company for the years ended December 31, 2025, 2024, and 2023 excludes $(1,143), $(1,789), and $(2,167), respectively, allocable to the redeemable noncontrolling interests for our joint venture arrangements.
[2]	Issuance of common stock on initial public offering is presented net of underwriting discounts and commissions, and offering-related expenses of $36.8 million and tax benefit of $5.3 million.
[3]	Proceeds from stock purchase contract issued under tangible equity units is presented net of underwriting discounts and commissions of $9.1 million.

Related Party Transactions - Additional Information (Details) - USD ($)	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
KKR Capital Markets, LLC
Related Party Transaction [Line Items]
Underwriting discounts and commissions paid	$ 7,400,000
Underwriter, arranger and transaction fees paid		$ 0	$ 3,700,000	$ 2,400,000
Monitoring Agreement \| KKR and WBA
Related Party Transaction [Line Items]
Percentage of EBITDA payable as advisory fee		1.00%
Termination fees paid	22,700,000
Selling, General, and Administrative Expenses \| Monitoring Agreement \| KKR and WBA
Related Party Transaction [Line Items]
Recognized monitoring and advisory fees	$ 700,000			$ 5,600,000

Discontinued Operations (Tables)

12 Months Ended

Dec. 31, 2025

Discontinued Operations and Disposal Groups [Abstract]

Summary of the Financial Results, Aggregate Carrying Amounts of Assets and Liabilities Held for Sale and Significant Non-cash Items and Purchases of Property and Equipment

The following table presents the financial results of the Community Living business (in thousands):


	For the Years Ended December 31,
	2025		2024		2023
Services revenue	$	1,234,403	$	1,194,258	$	1,135,159
Cost of services		840,172		872,250		840,361
Gross profit		394,231		322,008		294,798
Selling, general, and administrative expenses		254,753		223,588		205,743
Operating income of discontinued operations		139,478		98,420		89,055
Interest expense, net		29,917		37,840		52,694
Income from discontinued operations before income taxes		109,561		60,580		36,361
Income tax expense from discontinued operations		25,244		12,170		10,930
Income from discontinued operations, net of income taxes	$	84,317	$	48,410	$	25,431

The following table presents the aggregate carrying amounts of assets and liabilities held for sale for the Community Living business in the consolidated balance sheets (in thousands):


	December 31, 2025		December 31, 2024
Assets
Current assets:
Cash and cash equivalents	$	107	$	299
Accounts receivable, net of allowance for credit losses		136,875		125,872
Inventories		3,294		4,007
Prepaid expenses and other current assets		2,717		1,269
Total current assets held for sale		142,993		131,447
Property and equipment, net of accumulated depreciation of $104,314 and $110,417 at December 31, 2025 and 2024, respectively		83,465		69,715
Goodwill		307,640		307,640
Intangible assets, net of accumulated amortization		216,192		216,258
Operating lease right-of-use assets, net		129,005		88,717
Deferred income taxes, net		—		287
Other assets		2,894		5,343
Total assets held for sale	$	882,189	$	819,407
Liabilities
Current liabilities:
Trade accounts payable	$	25,081	$	17,366
Accrued expenses		59,038		60,791
Current portion of obligations under operating leases		32,749		30,755
Current portion of obligations under financing leases		7,691		8,651
Total current liabilities held for sale		124,559		117,563
Obligations under operating leases, net of current portion		57,771		58,147
Obligations under financing leases, net of current portion		12,766		18,461
Deferred income taxes, net		390		—
Long-term liabilities		508		569
Total liabilities held for sale	$	195,994	$	194,740


	For the Years Ended December 31,
	2025		2024		2023
Cash flows from operating activities of discontinued operations:
Depreciation and amortization	$	1,329	$	42,338	$	41,779
Share-based compensation		10,934		7,838		137
Impairment of long-lived assets		—		6,238		8,134

Cash flows from investing activities of discontinued operations:
Purchases of property and equipment		12,313		10,429		11,983

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-SubTopic 10
-Topic 360
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482099/360-10-50-3

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 360
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3A
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482099/360-10-50-3A

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 360
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3A
-Subparagraph (b)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482099/360-10-50-3A

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 205
-SubTopic 20
-Name Accounting Standards Codification
-Section 45
-Paragraph 11
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483475/205-20-45-11

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 205
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 3A
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-URI https://asc.fasb.org/1943274/2147483499/205-20-50-3A

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 4A
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-URI https://asc.fasb.org/1943274/2147483499/205-20-50-4A

Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
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Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
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-URI https://asc.fasb.org/1943274/2147483499/205-20-50-5B

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
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-URI https://asc.fasb.org/1943274/2147483499/205-20-50-5C

Reference 11: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 205
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-Name Accounting Standards Codification
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483499/205-20-50-5D

Reference 12: http://fasb.org/us-gaap/role/ref/legacyRef
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-URI https://asc.fasb.org/1943274/2147483499/205-20-50-7

Reference 13: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 360
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-Name Accounting Standards Codification
-Section 50
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-URI https://asc.fasb.org/1943274/2147482099/360-10-50-3A

Reference 14: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
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Reference 15: http://fasb.org/us-gaap/role/ref/legacyRef
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+ Details

Debt and Derivatives - Schedule of Total Outstanding Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Debt Instrument [Line Items]
Total debt	$ 2,569,744	$ 2,683,319
Less: debt issuance costs, net	62,200	72,736
Total debt, net of debt issuance costs	2,507,544	2,610,583
Less: current portion of long-term debt	52,340	48,725
Total long-term debt, net of current portion	$ 2,455,204	$ 2,561,858
First Lien Incremental Term Loan Tranche B-5 - Payable to Lenders at SOFR plus Applicable Margin
Debt Instrument [Line Items]
Rate	6.22%	6.86%
Total debt	$ 2,521,255	$ 2,546,787
Revolving Credit Loans - Payable to Lenders at SOFR plus Applicable Margin
Debt Instrument [Line Items]
Rate	6.47%	7.61%
Swingline/Base Rate - Payable to Lenders at ABR plus Applicable Margin
Debt Instrument [Line Items]
Rate	8.50%	9.75%
Total debt		$ 63,300
Amortizing Notes
Debt Instrument [Line Items]
Total debt	$ 31,360	53,804
Notes Payable and Other
Debt Instrument [Line Items]
Total debt	$ 17,129	$ 19,428

Segment Information - Schedule of Reportable Segments Reconcile of Segment Information (Details) - Operating Segments - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Segment Reporting Information [Line Items]
Cost of drugs	$ 9,782,109	$ 7,368,426	$ 5,291,630
Cost of services	885,356	797,286	711,304
Other direct costs	725,322	640,075	549,086
Segment selling, general, and administrative expenses	876,298	802,253	737,268
Segment depreciation and amortization expense	134,677	135,778	138,646
Segment EBITDA	776,156	599,952	540,374
Products
Segment Reporting Information [Line Items]
Revenues	11,445,777	8,754,282	6,522,450
Services
Segment Reporting Information [Line Items]
Revenues	1,464,787	1,317,932	1,168,566
Pharmacy Solutions
Segment Reporting Information [Line Items]
Cost of drugs	9,782,109	7,368,426	5,291,630
Other direct costs	725,322	640,075	549,086
Segment selling, general, and administrative expenses	502,042	462,219	426,521
Segment depreciation and amortization expense	107,198	111,103	115,749
Segment EBITDA	543,502	394,665	370,962
Pharmacy Solutions \| Products
Segment Reporting Information [Line Items]
Revenues	11,445,777	8,754,282	6,522,450
Provider Services
Segment Reporting Information [Line Items]
Cost of services	885,356	797,286	711,304
Segment selling, general, and administrative expenses	374,256	340,034	310,747
Segment depreciation and amortization expense	27,479	24,675	22,897
Segment EBITDA	232,654	205,287	169,412
Provider Services \| Services
Segment Reporting Information [Line Items]
Revenues	$ 1,464,787	$ 1,317,932	$ 1,168,566

Goodwill and Intangible Assets - Summary of Changes to Goodwill (Parenthetical) (Details) - USD ($) $ in Millions	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Net of accumulated impairment losses	$ 40.9	$ 40.9	$ 40.9

Income Taxes

12 Months Ended

Dec. 31, 2025

Income Tax Disclosure [Abstract]

Income Taxes

. Income Taxes

Income (loss) from continuing operations before income taxes consists of the following (in thousands):


	For the Years Ended December 31,
	2025		2024			2023
U.S. operations	$	137,723	$	(95,555	)	$	(213,971	)
Foreign operations		218		237			197
Income (loss) before income taxes	$	137,941	$	(95,318	)	$	(213,774	)

Income tax expense (benefit) attributable to income (loss) from continuing operations before income taxes is summarized as follows (in thousands):


	For the Years Ended December 31,
	2025		2024			2023
Current provision:
Federal	$	19,538	$	1,296		$	12,549
State		8,024		1,998			4,175
Foreign		35		50			39
Total current provision		27,597		3,344			16,763
Deferred provision:
Federal		1,524		(25,004	)		(40,106	)
State		4,024		(4,727	)		(8,165	)
Total deferred provision		5,548		(29,731	)		(48,271	)
Total income tax provision:
Federal		21,062		(23,708	)		(27,557	)
State		12,048		(2,729	)		(3,990	)
Foreign		35		50			39
Income tax expense (benefit)	$	33,145	$	(26,387	)	$	(31,508	)

A reconciliation of the U.S. federal income tax rate of 21.0% to income tax expense (benefit) expressed as a percent of pretax income (loss) is as follows (in thousands):


	For the Years Ended December 31,
	2025						2024						2023
	Amount			Rate			Amount			Rate			Amount			Rate
U.S. federal statutory tax rate	$	28,968			21.0	%	$	(20,017	)		21.0	%	$	(44,893	)		21.0	%
State and local income taxes, net of federal income tax effect (1)		9,518			6.9	%		(719	)		0.8	%		(5,029	)		2.4	%
Foreign tax effects		(11	)		0.0	%		15			0.0	%		12			0.0	%
Tax credits:
Employment tax credits		(1,752	)		(1.3	)%		(2,609	)		2.7	%		(2,963	)		1.4	%
Other tax credits		(200	)		(0.1	)%		(300	)		0.3	%		(350	)		0.2	%
Nontaxable or nondeductible items:
Legal claims		130			0.1	%		(12,915	)		13.5	%		24,150			(11.3	)%
Share based compensation		(12,663	)		(9.2	)%		4,380			(4.6	)%		(2,013	)		0.9	%
Executive compensation		8,187			5.9	%		1,017			(1.1	)%		—			—
Acquisition impacts		—			—			1,819			(1.9	)%		—			—
Other		2,290			1.7	%		2,950			(3.1	)%		(1,436	)		0.6	%
Changes in unrecognized tax benefits		(1,322	)		(1.0	)%		(8	)		0.1	%		1,014			(0.5	)%
Total	$	33,145			24.0	%	$	(26,387	)		27.7	%	$	(31,508	)		14.7	%

(1) State/local taxes in California, New York, New York City, Virginia, New Jersey and Florida made up the majority (greater than 50%) of the tax effect in this category.

On December 27, 2020, the Consolidated Appropriations Act was signed into law and extended the jobs credit provisions through 2025. Accordingly, jobs credits generated during the year have been recognized in the provision for income taxes for all years presented.

Net cash paid for income taxes consisted of the following (in thousands):


	For the Years Ended December 31,
	2025		2024		2023
Federal	$	18,431	$	19,347	$	27,297
Aggregated state and local jurisdictions		8,449		4,156		10,202
Disaggregated state and local jurisdictions:
Virginia	*			1,410		—
Foreign	90			40		—
Net cash paid for income taxes	$	26,970	$	24,953	$	37,499

* The amount of income taxes paid during the year does not meet the 5% disaggregation threshold.

The tax effects of temporary differences that give rise to significant portions of the deferred tax assets and liabilities are presented below (in thousands):


	December 31, 2025			December 31, 2024
Deferred tax assets:
Accrued expenses	$	53,538		$	44,957
Allowance for credit losses and contractual allowances		36,980			22,546
Net operating losses		13,389			18,796
Share-based compensation		22,361			15,799
IRC §163(j) interest		67,438			96,961
Operating lease liability		65,906			62,587
Interest rate swaps		93			—
Other		29,870			21,325
Deferred tax assets		289,575			282,971
Valuation allowances		(7,128	)		(8,968	)
Deferred tax assets, net		282,447			274,003

Deferred tax liabilities:
Operating lease right-of-use asset		(74,027	)		(60,587	)
Property and equipment		(11,789	)		(6,575	)
Goodwill and other intangible assets		(198,377	)		(190,272	)
Insurance recovery		(4,432	)		(8,677	)
Interest rate swaps		—			(2,604	)
Deferred tax liabilities		(288,625	)		(268,715	)
Deferred income taxes, net	$	(6,178	)	$	5,288

As of December 31, 2025, the Company has federal net operating loss (“NOL”) carryforwards of $11.3 million ($2.4 million deferred tax asset) that resulted from stock acquisitions the Company completed from 2013 through 2024. These NOLs are subject to limitations under Internal Revenue Code (“IRC”) §382. However, the Company expects that it will more-likely-than-not be able to use the recorded amount which takes into account the limitations of the carryforwards. The deferred tax asset for state NOL carryforwards is $4.3 million, net of the federal tax impact and valuation allowances of $7.1 million. The state NOLs have carryforward periods ranging from 1 to 20 years depending on the taxing jurisdiction.

The Company is subject to the business interest expense limitation under IRC §163(j), which generally caps deductible interest at 30% of adjusted taxable income. The limitation in any given year may be carried forward indefinitely and deducted as interest expense in future periods. The One Big Beautiful Bill Act, enacted July 4, 2025, introduced modifications to the §163(j) framework that may affect the Company’s future utilization of interest expense carryforwards. As of the reporting date, the Company has federal interest expense carryforwards of $259.6 million, resulting in a deferred tax asset of $54.5 million, and state deferred tax assets of $12.9 million available for utilization in future years.

A valuation allowance for deferred tax assets was provided as of December 31, 2025 and 2024 related to state income tax NOL carryforwards. The realization of deferred tax assets is dependent upon generating future taxable income when temporary differences

become deductible. Based upon the historical and projected levels of taxable income, we believe it is more-likely-than-not that we will realize the benefits of the deductible differences after consideration of the valuation allowance.

A reconciliation of the beginning and ending amount of total unrecognized tax benefits is as follows (in thousands):


	December 31, 2025			December 31, 2024
Balance at beginning of year	$	1,493		$	1,502
Decrease related to prior year tax positions		—			(9	)
Payments		(146	)		—
Lapse of statute of limitations		(1,322	)		—
Balance at end of year	$	25		$	1,493

The potential benefits included in the balance of total unrecognized tax benefits at December 31, 2025 and 2024 are immaterial, which if recognized, would have an immaterial effect on the effective tax rate in each respective year. Unrecognized tax benefits that reduce a NOL, similar tax loss or tax credit carryforward are presented as a reduction to deferred income taxes.

We file numerous consolidated and separate income tax returns in the U.S. federal and various state and foreign jurisdictions. With few exceptions, we are no longer subject to income tax examinations by the taxing authorities for years prior to 2020. We believe that we have appropriate support for the income tax positions taken and to be taken on our income tax returns and that our accruals for income tax liabilities are adequate for all open years based on an assessment of many factors including past experience and interpretations of the tax laws as applied to the facts of each matter. Total accrued interest and penalties as of December 31, 2025 and 2024 are not material and are included in accrued expenses on the consolidated balance sheets.

- Definition

The entire disclosure for income tax.

+ References

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+ Details

Goodwill and Intangible Assets - Summary of Changes to Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Goodwill [Line Items]
Goodwill, Beginning balance	$ 2,363,884	$ 2,300,772
Goodwill added through acquisitions	181,472	63,207
Measurement period adjustments	128	237
Foreign currency adjustments	189	(332)
Goodwill, Ending balance	2,545,673	2,363,884
Pharmacy Solutions
Goodwill [Line Items]
Goodwill, Beginning balance	841,052	833,989
Goodwill added through acquisitions	0	7,063
Measurement period adjustments	0	0
Foreign currency adjustments	0	0
Goodwill, Ending balance	841,052	841,052
Provider Services
Goodwill [Line Items]
Goodwill, Beginning balance	1,522,832	1,466,783
Goodwill added through acquisitions	181,472	56,144
Measurement period adjustments	128	237
Foreign currency adjustments	189	(332)
Goodwill, Ending balance	$ 1,704,621	$ 1,522,832

- Definition

Amount, after accumulated impairment loss, of asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

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- Definition

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+ Details

Detail of Certain Balance Sheet Accounts (Tables)

12 Months Ended

Dec. 31, 2025

Disclosure Text Block Supplement [Abstract]

Schedule of Prepaid Expenses and Other Current Assets

Prepaid expenses and other current assets consist of the following (in thousands):


	December 31, 2025		December 31, 2024
Non-trade receivables	$	38,196	$	45,428
Rebate receivable		32,407		49,538
Prepaid insurance		13,255		13,892
Inventory returns receivable		11,019		11,245
Prepaid maintenance		6,025		3,644
Income tax receivable		864		13,468
Interest rate swaps		—		10,633
Other prepaid expenses and current assets		16,826		13,462
Total prepaid expenses and other current assets	$	118,592	$	161,310

Schedule of Other Assets

Other assets consist of the following (in thousands):


	December 31, 2025		December 31, 2024
Other investments	$	7,481	$	1,427
Insurance recoveries		7,251		7,564
Cloud computing		6,017		7,362
Deposits		5,722		6,733
Deferred compensation		4,702		3,777
Notes receivable		4,012		8,577
Deferred debt issuance costs		1,764		2,470
Interest rate swaps		1,181		—
Equity method investments		721		420
Other assets		861		798
Total other assets	$	39,712	$	39,128

Schedule of Accrued Expenses

Accrued expenses consist of the following (in thousands):


	December 31, 2025		December 31, 2024
Wages and payroll taxes	$	131,162	$	98,245
Checks in excess of cash balance		34,824		27,643
Compensated absences		31,543		24,360
Workers compensation insurance reserves		24,897		19,966
Health insurance reserves		15,389		14,934
Property insurance reserves		11,170		9,879
Legal settlements and professional fees		10,525		13,982
Deferred revenue		9,039		10,196
General and professional liability insurance reserves		7,696		8,328
Automobile insurance reserves		5,585		21,353
Taxes other than income taxes		3,506		1,985
Interest		1,507		8,779
Interest rate swaps		1,405		—
Contingent consideration		—		3,136
Other		44,776		32,960
Total accrued expenses	$	333,024	$	295,746

Schedule of Long-Term Liabilities

Long-term liabilities consist of the following (in thousands):


	December 31, 2025		December 31, 2024
Workers compensation insurance reserves	$	25,369	$	25,360
General and professional liability insurance reserves		25,032		21,182
Automobile insurance reserves		9,849		9,034
Deferred compensation		4,702		3,777
Contingent consideration		750		5,250
Interest rate swaps		156		—
Other		707		6,587
Total long-term liabilities	$	66,565	$	71,190

Debt and Derivatives - Summary of Maturities of Long-Term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Debt Disclosure [Abstract]
2026	$ 52,340
2027	32,135
2028	40,549
2029	25,549
2030	25,549
Thereafter	2,393,622
Total debt	$ 2,569,744	$ 2,683,319

Tangible Equity Units - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	1 Months Ended	12 Months Ended
	Jan. 31, 2024	Dec. 31, 2025	Dec. 31, 2024	May 01, 2024
Minimum
Class of Stock [Line Items]
Mandatory conversion to common stock		26,200,000
Average applicable market value		$ 13.00
Maximum
Class of Stock [Line Items]
Mandatory conversion to common stock		30,800,000
Average applicable market value		$ 15.28
Senior Amortizing Note
Class of Stock [Line Items]
Maturity date	Feb. 01, 2027
Amortizing Notes
Class of Stock [Line Items]
Maturity date	Feb. 01, 2027
Long-term portion of the amortizing notes		$ 6.6	$ 32.9
Short-term portion of the amortizing notes		24.8	20.9
Cash installment per unit	$ 0.8438			$ 0.8531
TEU principal and interest payments		$ 27.0	$ 20.3
Purchase Contracts
Class of Stock [Line Items]
Units converted at holder's option		4,384,020	31,211
TEUs
Class of Stock [Line Items]
Tangible equity unit	8,000,000
TEU price per share	$ 50		$ 50

Tangible Equity Units (Tables)

12 Months Ended

Dec. 31, 2025

Equity [Abstract]

Schedule of Proceeds from Issuance Allocated to Equity and Debt Based on Relative Fair Value of each TEU

The proceeds from the issuance were allocated to equity and debt based on the relative fair value of the respective components of each TEU as follows (in thousands, except per unit values):


	Equity Component		Debt Component		Total
Fair value per unit	$	41.3382	$	8.6618	$	50.00

Gross proceeds	$	330,706	$	69,294	$	400,000
Less: issuance costs		9,095		1,905		11,000
Net proceeds	$	321,611	$	67,389	$	389,000

Schedule of Number of Common Stock Issued Based on 20 Day Volume Weighted-Average Price of Common Stock


VWAP of BTSG Common Stock		Common Stock Issued
Greater than $15.28		3.2733 shares (minimum settlement rate)
Equal to or less than $15.28 but greater than or equal to $13.00		$50 divided by VWAP
Less than $13.00		3.8461 shares (maximum settlement rate)

Fair Value - Additional Information (Details) - USD ($)	12 Months Ended
Fair Value - Additional Information (Details) - USD ($)	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Goodwill impairment charges	$ 0	$ 0
Impairment of definite-lived intangible assets	$ 10,800,000	$ 1,700,000	$ 1,500,000
Impairment, Intangible Asset, Finite-Lived, Statement of Income or Comprehensive Income [Extensible Enumeration]	Selling, General and Administrative Expense	Selling, General and Administrative Expense	Selling, General and Administrative Expense
Fair Value Measurement Non-Recurring
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Goodwill impairment charges	$ 0	$ 0
Impairment of definite-lived intangible assets	$ 12,600,000	$ 12,600,000
Impairment, Intangible Asset, Finite-Lived, Statement of Income or Comprehensive Income [Extensible Enumeration]	Selling, General and Administrative Expense	Selling, General and Administrative Expense
Impairment of operating lease right-of-use assets	$ 4,000,000	$ 4,000,000

- Definition

+ References + Details

Income Taxes - Schedule of Income (Loss) from Continuing Operations Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Income Tax Disclosure [Abstract]
U.S. Operations	$ 137,723	$ (95,555)	$ (213,971)
Foreign Operations	218	237	197
Income (loss) from continuing operations before income taxes	$ 137,941	$ (95,318)	$ (213,774)

- Definition

Amount of income (loss) from continuing operations, including income (loss) from equity method investments, before deduction of income tax expense (benefit), and income (loss) attributable to noncontrolling interest.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
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+ Details

Income Taxes - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Operating Loss Carryforwards [Line Items]
Net operating loss carryforwards	$ 11,300,000
U.S. federal statutory tax rate	21.00%	21.00%	21.00%
Deferred tax assets, net operating loss carryforwards	$ 13,389	$ 18,796
Operating loss carryforwards, valuation allowances	$ 7,100,000
Percentage of adjusted taxable income for interest expense subject to limitation	30.00%
Accrued interest and penalties	$ 0	$ 0
Federal
Operating Loss Carryforwards [Line Items]
Deferred tax assets, net operating loss carryforwards	2,400,000
Interest expense carryforwards	259,600,000
Deferred tax assets, interest expense carryforwards	54,500,000
State
Operating Loss Carryforwards [Line Items]
Deferred tax assets, net operating loss carryforwards	4,300,000
Deferred tax assets, interest expense carryforwards	$ 12,900,000
State \| Minimum
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards period	1 year
State \| Maximum
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards period	20 years

Acquisitions - Additional Information (Details) $ in Thousands				1 Months Ended	3 Months Ended		12 Months Ended
	Dec. 31, 2025 Branch	Dec. 01, 2025 Branch	Sep. 01, 2024 USD ($) shares	Dec. 31, 2025 USD ($) Branch	Sep. 30, 2024	Mar. 31, 2024	Dec. 31, 2025 USD ($) Acquisitions Branch	Dec. 31, 2024 USD ($) Acquisitions
Business Combination [Line Items]
Shares issued for payment of acquisition								$ 31,081
Gateway Pediatric Therapy LLC
Business Combination [Line Items]
Redeemed noncontrolling interest percentage						30.00%
Harvest Grove LTC, LLC
Business Combination [Line Items]
Redeemed noncontrolling interest percentage					45.00%
Pharmacy Solutions
Business Combination [Line Items]
Consideration transferred to asset acquired							$ 27,000
Provider Services
Business Combination [Line Items]
Consideration transferred to asset acquired							$ 18,900
2025 Acquisitions
Business Combination [Line Items]
Number of businesses acquired \| Acquisitions							2
Consideration transferred to asset acquired							$ 8,500
Cash acquired from acquisition							0
Transaction costs							$ 14,500
2025 Acquisitions \| Provider Services
Business Combination [Line Items]
Number of businesses acquired \| Acquisitions							3
Consideration transferred to asset acquired							$ 247,000
Amedisys and LHC Branches Acquisition
Business Combination [Line Items]
Number of branches \| Branch							110
Number of branches acquired \| Branch	4	103
Number of branches to be acquired \| Branch				3
Consideration transferred to asset acquired				$ 238,459			$ 246,400
Definite-lived intangible assets estimated weighted average useful life							10 years
Proforma revenue				25,300			$ 13,255,587	10,413,024
Proforma operating (loss) income				$ 1,200			318,968	135,722
Amedisys and LHC Branches Acquisition \| Indefinite-lived Licenses
Business Combination [Line Items]
Intangible assets							56,000
Amedisys and LHC Branches Acquisition \| Definite-lived Licenses
Business Combination [Line Items]
Intangible assets							62,900
Haven Hospice, Inc.
Business Combination [Line Items]
Consideration transferred to asset acquired			$ 64,750
Cash payment			15,000
Business combination seller note payable			$ 15,000
Shares issued for payment of acquisition, shares \| shares			2,471,251
Shares issued for payment of acquisition			$ 30,000
Share value calculated			$ 30,000
Sellers restriction trading lock up period			180 days
Proforma revenue							68,900	19,800
Proforma operating (loss) income							7,800	1,000
Haven Hospice, Inc. \| Indefinite-lived Licenses
Business Combination [Line Items]
Intangible assets			$ 14,800
Haven Hospice, Inc. \| Trade Names
Business Combination [Line Items]
Intangible assets			$ 5,100
Definite-lived intangible assets estimated weighted average useful life			10 years
2024 Acquisitions
Business Combination [Line Items]
Consideration transferred to asset acquired								$ 110,600
2024 Acquisitions \| Pharmacy Solutions and Provider Services
Business Combination [Line Items]
Number of businesses acquired \| Acquisitions								8
Pharmacy Solutions and Provider Services Segments
Business Combination [Line Items]
Consideration transferred to asset acquired								$ 45,893
Definite-lived intangible assets estimated weighted average useful life								14 years 10 months 24 days
Proforma revenue							81,300	$ 59,900
Proforma operating (loss) income							(400)	5,000
Non-cash intangible impairment							$ 3,000
Estimated goodwill deductible for tax								12,000
Transaction costs								3,400
Pharmacy Solutions and Provider Services Segments \| Indefinite-lived Licenses
Business Combination [Line Items]
Intangible assets								2,100
Pharmacy Solutions and Provider Services Segments \| Definite-lived Licenses
Business Combination [Line Items]
Intangible assets								5,700
Pharmacy Solutions and Provider Services Segments \| Customer Relationships
Business Combination [Line Items]
Intangible assets								22,300
Pharmacy Solutions and Provider Services Segments \| Trade Names
Business Combination [Line Items]
Intangible assets								500
Pharmacy Solutions and Provider Services Segments \| Covenants Not to Compete
Business Combination [Line Items]
Intangible assets								$ 600

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2025

Goodwill and Intangible Assets Disclosure [Abstract]

Summary of Changes to Goodwill

A summary of changes to goodwill is as follows (in thousands):


	Goodwill
	Pharmacy Solutions		Provider Services			Total
Goodwill at January 1, 2024*	$	833,989	$	1,466,783		$	2,300,772
Goodwill added through acquisitions		7,063		56,144			63,207
Measurement period adjustments		—		237			237
Foreign currency adjustments		—		(332	)		(332	)
Goodwill at December 31, 2024*	$	841,052	$	1,522,832		$	2,363,884
Goodwill added through acquisitions		—		181,472			181,472
Measurement period adjustments		—		128			128
Foreign currency adjustments		—		189			189
Goodwill at December 31, 2025*	$	841,052	$	1,704,621		$	2,545,673

* For the periods presented, the carrying amount of goodwill is presented net of accumulated impairment losses of $40.9 million, which were incurred in fiscal year 2022.

Schedule of Intangible Assets

Intangible assets are as follows (in thousands):


	December 31, 2025						December 31, 2024
	Gross		Accumulated Amortization		Net Carrying Value		Gross		Accumulated Amortization		Net Carrying Value		Life (Years)
Customer relationships	$	502,160	$	356,146	$	146,014	$	542,137	$	335,647	$	206,490	5-20
Trade names		318,768		154,601		164,167		332,977		140,020		192,957	2-20
Licenses		67,395		18,886		48,509		68,425		17,528		50,897	10-20
Doctor/payor network		5,650		4,987		663		12,730		10,965		1,765	5-8
Covenants not to compete		6,654		4,717		1,937		8,790		5,886		2,904	2-7
Other intangible assets		10,940		7,925		3,015		10,940		6,362		4,578	5-7
Total definite-lived assets	$	911,567	$	547,262	$	364,305	$	975,999	$	516,408	$	459,591
Licenses		193,250		—		193,250		135,633		—		135,633	Indefinite
Total intangible assets	$	1,104,817	$	547,262	$	557,555	$	1,111,632	$	516,408	$	595,224

Schedule of Definite-Lived Intangible Assets, Amortization Expense

As of December 31, 2025, total estimated amortization expense for the Company’s definite-lived intangible assets for the next five years and thereafter is as follows (in thousands):


2026	$	79,888
2027		46,935
2028		39,876
2029		34,000
2030		33,108
Thereafter		130,498
	$	364,305

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 350
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-Name Accounting Standards Codification
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+ Details

Significant Accounting Policies - Additional Information (Details)

1 Months Ended

12 Months Ended

Oct. 22, 2025

Jan. 31, 2024

USD ($)

Unit

$ / shares

$ / Unit

Dec. 31, 2025

USD ($)

Unit

Segment

Dec. 31, 2024

USD ($)

Dec. 31, 2023

USD ($)

Summary Of Significant Accounting Policy [Line Items]

Tangible equity units issued | Unit

8,000,000

Tangible equity units, rate

6.75%

Tangible equity units, stated price per unit | $ / Unit

Net proceeds from tangible equity units issuance

$ 389,000,000

Net proceeds from offering

$ 656,485,000

Accounts receivable, allowance for credit loss

$ 76,600,000

45,000,000

Provisions of credit losses

56,200,000

34,000,000

Write offs

29,500,000

40,700,000

Recoveries and other changes

$ 4,900,000

5,800,000

Ownership percentage

50.00%

Equity method investments

$ 721,000

420,000

Number of reporting unit | Unit

$ 10,800,000

$ 1,700,000

$ 1,500,000

Impairment, Intangible Asset, Finite-Lived, Statement of Income or Comprehensive Income [Extensible Enumeration]

Selling, General and Administrative Expense

Deferred offering costs

5,600,000

$ 0

Workers compensation, discount rate

4.00%

4.50%

Impairment of property and equipment

$ 0

Number of operating segments | Segment

ASU 2023-09

Summary Of Significant Accounting Policy [Line Items]

Accounting standards update adopted

true

Accouting standards update, immaterial effect

true

ASU 2023-07

Summary Of Significant Accounting Policy [Line Items]

Accounting standards update adopted

true

Accouting standards update, immaterial effect

true

Minimum

Summary Of Significant Accounting Policy [Line Items]

Estimated useful lives

2 years

Maximum

Summary Of Significant Accounting Policy [Line Items]

Estimated useful lives

20 years

Provider Services

Summary Of Significant Accounting Policy [Line Items]

Number of reportable segments | Segment

Equipment and Software | Minimum

Summary Of Significant Accounting Policy [Line Items]

Property and equipment, estimated useful life

3 years

Equipment and Software | Maximum

Summary Of Significant Accounting Policy [Line Items]

Property and equipment, estimated useful life

10 years

Buildings

Summary Of Significant Accounting Policy [Line Items]

Property and equipment, estimated useful life

20 years

Leasehold Improvements | Minimum

Summary Of Significant Accounting Policy [Line Items]

Property and equipment, estimated useful life

1 year

Leasehold Improvements | Maximum

Summary Of Significant Accounting Policy [Line Items]

Property and equipment, estimated useful life

15 years

Other Assets

Summary Of Significant Accounting Policy [Line Items]

Equity method investments

$ 700,000

October 2025 Offering

Summary Of Significant Accounting Policy [Line Items]

Common stock shares purchased from underwriter | shares

1,500,000

Common Stock

Summary Of Significant Accounting Policy [Line Items]

Shares issued | shares

^[1]

53,333,334

Net proceeds from offering

$ 656,500,000

Common Stock | Initial Public Offering

Summary Of Significant Accounting Policy [Line Items]

Shares issued | shares

53,333,334

Common stock price per share | $ / shares

$ 13

Common Stock | October 2025 Offering

Summary Of Significant Accounting Policy [Line Items]

Shares issued | shares

15,000,000

Selling, General, and Administrative Expenses

Summary Of Significant Accounting Policy [Line Items]

Right-of-use asset impairment

$ 1,800,000

$ 2,300,000

$ 1,000,000

[1]	Issuance of common stock on initial public offering is presented net of underwriting discounts and commissions, and offering-related expenses of $36.8 million and tax benefit of $5.3 million.